Interrelationships between tumor proliferative activity, leucocyte and macrophage infiltration, systemic inflammatory response, and survival in patients selected for potentially curative resection for gastroesophageal cancer

Crumley, A.B.C., Going, J.J., Hilmy, M., Dutta, S., Tannahill, C., McKernan, M., Edwards, J. , Stuart, R.C. and McMillan, D.C. (2011) Interrelationships between tumor proliferative activity, leucocyte and macrophage infiltration, systemic inflammatory response, and survival in patients selected for potentially curative resection for gastroesophageal cancer. Annals of Surgical Oncology, 18(9), pp. 2604-2612. (doi:10.1245/s10434-011-1658-7)

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Abstract

Background: A number of accepted criteria, including pathological tumor, node, metastasis system stage, lymph node metastasis, and tumor differentiation, predict survival in patients undergoing surgery for gastroesophageal cancer. We examined the interrelationships between standard clinicopathological factors, systemic and local inflammatory responses, tumor proliferative activity, and survival. Methods: The interrelationships between the systemic inflammatory response (Glasgow prognostic score, mGPS), standard clinicopathological factors, local inflammatory response (Klintrup criteria, macrophage infiltration), and tumor proliferative activity (Ki-67) were examined by immunohistochemistry in 100 patients (44 esophageal [19 squamous, 25 adenocarcinoma], 19 junctional, and 37 gastric cancers) selected for potentially curative resection. Results: The minimum follow-up was 59 months. On multivariate survival analysis, lymph node ratio (hazard ratio [HR] 1.63, 95% confidence interval [CI] 1.11–2.40, P < 0.05), tumor differentiation (HR 2.63, 95% CI 1.45–4.77, P = 0.001), mGPS (HR 3.91, 95% CI 1.96–8.11, P < 0.001), Klintrup score (HR 3.47, 95% CI 1.14–10.55, P < 0.05), and Ki-67 (HR 0.67, 95% CI 0.47–0.96, P < 0.05) were independently associated with cancer-specific survival. A higher lymph node ratio was associated with poor tumor differentiation (P < 0.05), low-grade Klintrup criteria (P < 0.005), and low tumor proliferative activity (P < 0.05). Conclusion: Tumor proliferation rate and local and systemic inflammatory responses are important predictors of survival, albeit in a heterogeneous cohort of patients including esophageal, junctional, and gastric cancers. These scores may be combined with accepted tumor-based factors to improve prediction of outcome.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Tannahill, Ms Claire and Dutta, Mr Sumanta and McMillan, Professor Donald and Edwards, Professor Joanne and Stuart, Mr Robert and Going, Dr James
Authors: Crumley, A.B.C., Going, J.J., Hilmy, M., Dutta, S., Tannahill, C., McKernan, M., Edwards, J., Stuart, R.C., and McMillan, D.C.
Subjects:R Medicine > RC Internal medicine > RC0254 Neoplasms. Tumors. Oncology (including Cancer)
College/School:College of Medical Veterinary and Life Sciences > Institute of Cancer Sciences
Journal Name:Annals of Surgical Oncology
ISSN:1068-9265
Published Online:16 March 2011

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