J Cancer 2019; 10(17):3883-3892. doi:10.7150/jca.31286

Research Paper

Novel preoperative nutritional assessment tool and prognostic model for ESCC patients

Jinming Xu1, Jinlin Cao1, Ying Wang2, Xin Yao3, Yiqing Wang1, Zhehao He1, Wang Lv1, Jian Hu1 ✉

1. Department of Thoracic Surgery, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
2. Operating Room, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.
3. Department of Gastroenterology, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310003, China.

Abstract

Background: Esophageal squamous cell carcinoma (ESCC) is one of the most aggressive tumor types worldwide, and malnutrition prevails in these patients. However, there is no preoperative nutritional assessment tool specifically designed for patients with ESCC.

Methods: Patients who received esophagectomy from 2004 to 2016 were consecutively included. The preoperative nutritional risk factors for ESCC were screened by univariate and multivariate Cox regression analysis to construct a new nutritional scoring tool. A prognostic model of ESCC based on the new scoring tool was further proposed.

Results: A total of 510 ESCC patients were enrolled. A novel BLUT (BMI-lymphocyte-uric acid-triglyceride) scoring tool based on BMI, lymphocyte count, uric acid level, and triglyceride level was proposed, which could effectively predict the prognosis of ESCC patients (log rank P<0.001), and it was better than the traditional nutritional assessment tools. The C-index and 95% confidence interval (CI) of the nomogram based on the BLUT scoring tool was 0.735(0.698-0.772). It had good prognostic efficacy and was significantly better than the model based on T stage and N stage (P=0.038). The calibration curve of internal and external validation suggested a good fitting effect with the real situation in judging the 1-year, 3-year, and 5-year survival status.

Conclusions: The BULT scoring tool could distinguish the heterogeneity of preoperative nutritional status and the BLUT-based nomogram had good prognostic performance for ESCC patients.

Keywords: esophageal squamous cell carcinoma, nutritional assessment tool, prognostic model

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) license (https://creativecommons.org/licenses/by-nc/4.0/). See http://ivyspring.com/terms for full terms and conditions.
How to cite this article:
Xu J, Cao J, Wang Y, Yao X, Wang Y, He Z, Lv W, Hu J. Novel preoperative nutritional assessment tool and prognostic model for ESCC patients. J Cancer 2019; 10(17):3883-3892. doi:10.7150/jca.31286. Available from http://www.jcancer.org/v10p3883.htm