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Lindenmann, J; Fink-Neuboeck, N; Avian, A; Pichler, M; Habitzruther, M; Maier, A; Smolle-Juettner, FM.
Preoperative Glasgow Prognostic Score as additional independent prognostic parameter for patients with esophageal cancer after curative esophagectomy.
Eur J Surg Oncol. 2017; 43(2):445-453 Doi: 10.1016/j.ejso.2016.10.015
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Führende Autor*innen der Med Uni Graz
Fink-Neuböck Nicole
Lindenmann Jörg
Co-Autor*innen der Med Uni Graz
Avian Alexander
Maier Alfred
Pichler Martin
Smolle-Juettner Freyja-Maria

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Inflammation accelerates tumor growth followed by reduced survival in patients with cancer. The aim of this study was to evaluate the prognostic relevance of preoperatively increased levels of C-reactive protein (CRP) and the corresponding Glasgow Prognostic Score (GPS) on patients with esophageal carcinoma undergoing curative esophagectomy. The data of 174 operated esophageal cancer patients were evaluated retrospectively. Patient's demographic and clinico-pathological data, tumor specific data, preoperative plasma levels of CRP and albumin, the corresponding GPS, overall survival (OS) and progression free survival (PFS) were assessed. 103 (59.2%) had adenocarcinoma and 71 (40.8%) had squamous cell carcinoma. 71 patients (43%) had elevated CRP concentrations. 118 patients (71%) had GPS 0, 41 (25%) GPS 1 and 8 (4%) GPS 2. Mean GPS was 0.3 (0-2). 5-year OS was higher in patients with normal CRP than in those with increased CRP (68% vs. 39%; p = 0.007). 5-year OS in patients with GPS 0 and GPS 1 and 2 were 65% and 31% (p = 0.001). 5-year OS for the whole cohort was 56% (1 year: 83%, 3 years: 64%). Recurrence rate was 16.1% closely associated with GPS (p = 0.002). Median follow-up was 23 months (0-118 months). In multivariate analysis GPS, lymph node involvement, T stage and tumor histology were the independent prognostic parameters (p = 0.004, <0.001, 0.035, 0.010). Preoperatively increased GPS is significantly associated with reduced postoperative survival and tumor recurrence. The GPS as an independent prognosticator should be interpreted together with the TNM stage when the further postoperative treatment has to be scheduled. Copyright © 2016 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
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Adenocarcinoma - metabolism
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Adult -
Aged -
Aged, 80 and over -
Biomarkers, Tumor - metabolism
C-Reactive Protein - metabolism
Carcinoma, Squamous Cell - metabolism
Carcinoma, Squamous Cell - mortality
Carcinoma, Squamous Cell - pathology
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Esophageal Neoplasms - metabolism
Esophageal Neoplasms - mortality
Esophageal Neoplasms - pathology
Esophageal Neoplasms - surgery
Esophagectomy -
Female -
Humans -
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Middle Aged -
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Esophageal cancer
C-reactive protein
Glasgow Prognostic Score
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