Table_3_Modified Systemic Inflammation Score Is an Independent Predictor of Long-Term Outcome in Patients Undergoing Surgery for Adenocarcinoma of the Esophagogastric Junction.DOCX

Background: The modified systemic inflammation score (mSIS), which is calculated by a composite score of the lymphocyte-to-monocyte ratio and the albumin content in serum, is identified as the new score to predict the prognosis for various cancers. However, its significance for patients with adenocarcinoma of esophagogastric junction (AEJ), who receive surgery, remains unclear.
Methods: This study retrospectively analyzed 317 patients with AEJ receiving surgery between September 2010 and December 2016. The associations between the mSIS and the clinicopathological features, overall survival (OS), as well as relapse-free survival (RFS), were assessed. In addition, the time-dependent receiver operating characteristic (t-ROC) curve analysis was performed for comparing the value of those scoring systems in predicting patient prognosis.
Results: Of the 317 cases, 119 were rated as mSIS 0, 123 as mSIS 1, and 75 as mSIS 2. Besides, mSIS was significantly related to age and tumor size. On multivariate analysis, mSIS was identified as a predictor to independently predict OS (p < 0.001) along with RFS (p < 0.001), and a significantly strong correlation was observed at the advanced pTNM stages based on the mSIS system. In the subgroup analysis of adjuvant chemotherapy and surgery alone, mSIS was still the predictor for independently predicting patient OS (p < 0.001) together with RFS (p < 0.001) for the two groups. T-ROC analysis showed that mSIS was more accurate than controlling nutritional status score in predicting OS and RFS.
Conclusions: The mSIS can serve as an easy, useful scoring system to independently predict the preoperative survival for AEJ cases undergoing surgery.

背景：改良全身炎症评分（modified systemic inflammation score，mSIS）由淋巴细胞与单核细胞比值及血清白蛋白含量的复合评分计算所得，被确立为预测多种癌症预后的新型评分系统。然而，其对于接受手术治疗的食管胃结合部腺癌（adenocarcinoma of esophagogastric junction，AEJ）患者的临床意义仍不明确。方法：本研究回顾性分析了2010年9月至2016年12月间317例接受手术治疗的食管胃结合部腺癌患者。评估了mSIS与临床病理特征、总生存期（overall survival，OS）及无复发生存期（relapse-free survival，RFS）之间的相关性。此外，采用时间依赖性受试者工作特征（time-dependent receiver operating characteristic，t-ROC）曲线分析，对比各评分系统预测患者预后的价值。结果：317例患者中，119例被评为mSIS 0级，123例为mSIS 1级，75例为mSIS 2级。此外，mSIS与患者年龄及肿瘤大小显著相关。多因素分析显示，mSIS可独立预测OS（p<0.001）与RFS（p<0.001），且在高级别pTNM分期中，基于mSIS系统的相关性显著增强。在辅助化疗与单纯手术亚组分析中，mSIS仍可独立预测两组患者的OS（p<0.001）与RFS（p<0.001）。t-ROC分析显示，mSIS在预测OS与RFS方面的准确性优于控制营养状况评分。结论：mSIS可作为一种简便实用的评分系统，独立预测接受手术治疗的食管胃结合部腺癌患者的术前生存期。