Figures (3)  Tables (6)

    • Figure 1. 

      Kaplan-Meier curves for RFS significantly differed between the high and low PNI groups (p < 0.05). RFS, recurrence-free survival; PNI, prognostic nutritional index.

    • Figure 2. 

      Kaplan-Meier curves for RFS significantly differed between the high and low CRP groups (p < 0.05). RFS, recurrence-free survival; CRP, C-reactive protein.

    • Figure 3. 

      Kaplan-Meier curves for RFS were significantly worse in patients with postoperative respiratory complications than in patients without postoperative respiratory complications (p < 0.05). RFS, recurrence-free survival.

    • PNI (cutoff = 44.2, n = 104) p value CRP (cutoff = 21.7) p value
      PNI >44.2 PNI <44.2 CRP <21.7 CRP >21.7
      Patients, n 111 83 21 0.111 85 26 0.84
      Age, years 66.3±7.77 65.64±7.91 68.67±7.64 66.5±6.37 66.24±8.18
      Gender
        Male 93 73 14 0.041 70 23 0.557
        Female 18 10 7 15 3
      Location
        Upper 23 15 6 0.146 13 10 0.019
        Middle 62 51 8 53 9
        Lower 26 17 7 19 7
      TNM classification
        T factors
          T1b 55 43 7 0.44 44 11 0.646
          T2 13 9 3 9 4
          T3 34 24 9 26 8
          T4 9 7 2 6 3
        N factors
          N0 45 34 6 0.831 34 11 0.543
          N1 29 22 6 20 9
          N2 22 17 5 19 3
          N3 15 10 4 12 3
        M factors
          M0 104 77 20 1.00 78 26 0.196
          M1 7 6 1 7 0
        pStage*
          Ⅰ 39 30 5 0.288 32 7 0.087
          Ⅱ 16 13 1 8 8
          Ⅲ 36 26 10 29 7
          Ⅳ 20 14 5 16 4
      Procedures
        Thoracoscopic 83 11 7 0.124 15 4 0.735
        Ivor Lewis 17 61 12 58 20
        THE 11 11 2 12 2
      PNI, prognostic nutritional index; CRP, C-reactive protein; THE, transhiatal esophagectomy. * UICC TNM 8th edition.

      Table 1. 

      Clinical characteristics in this study

    • Covariants Cutoff value (FP, TP) HR RFS HR OS
      95% CI p value 95% CI p value
      Age 1.068 0.819–1.394 0.627 1.117 0.855–1.461 0.417
      Gender 0.969 0.432–2.176 0.94 0.859 0.362–2.036 0.729
      pT 1.622 1.247–2.109 0.001* 1.521 1.159–1.995 0.003*
      pN 1.658 1.270–2.165 0.001* 1.674 1.265–2.214 0.001*
      pM 1.477 0.528–4.133 0.457 1.333 0.475–3.741 0.585
      pTNM 1.829 1.378–2.428 0.001* 1.726 1.296–2.300 0.001*
      Tumor location 0.467 0.292–0.747 0.002* 0.394 0.243–0.637 0.001*
      Operative procedures 0.685 0.392–1.197 0.184 0.837 0.491–1.429 0.515
      Preoperative PNI 44.2 (0.891, 0.333) 0.292 0.155–0.552 0.001* 0.315 0.164–0.606 0.001*
      Preoperative albumin, g/dL 3.5 (0.897, 0.279) 0.459 0.251–0.839 0.011* 0.471 0.254–0.876 0.017*
      NLR 2.272 (0.484, 0.600) 0.84 0.459–1.536 0.571 0.716 0.382–1.342 0.297
      BMI, kg/m2 21.4 (0.441, 0.698) 0.669 0.354–1.263 0.216 0.686 0.364–1.295 0.246
      Blood loss, g 159 (0.515, 0.767) 2.549 1.313–4.946 0.006* 2.467 1.242–4.897 0.01*
      CRPmax 21.7 (0.809, 0.326) 1.944 1.047–3.608 0.0321* 1.735 0.9023–3.337 0.0942
      CRP/albumin ratio 8.512 (0.735, 0.395) 1.702 0.939–3.084 0.076 1.726 0.933–3.193 0.081
      Operation time 360 min (median) 1.369 0.735–2.550 0.322 1.26 0.690–2.304 4.522
      Hospital stay 42 days (median) 1.161 0.629–2.144 0.663 1.32 0.724–2.409 0.365
      Postoperative complications 1.129 0.625–2.041 0.625 1.056 0.583–1.941 0.855
      OS, overall survival; RFS, recurrence-free survival; FP, false positive TP, true positive; PNI, prognostic nutritional index; CRP, Creactive protein; NLR, neutrophil-to-lymphocyte ratio. * Statistically significant.

      Table 2. 

      Univariate analysis for OS and RFS in the present study

    • Covariants HR OS after IPTW 95% CI p value HR RFS after IPTW 95% CI p value
      PNI 0.391 0.177–0.863 0.02* 0.36 0.178–0.729 0.005*
      CRPmax 1.507 0.760–2.988 0.24 1.841 1.014–3.342 0.045*
      NLR 0.878 0.460–1.674 0.694 0.913 0.496–1.679 0.771
      Blood loss 1.528 0.757–3.085 0.236 1.479 0.769–2.842 0.24
      BMI 0.767 0.393–1.496 0.437 0.698 0.361–1.347 0.284
      Albumin (preoperative) 0.502 0.253–0.995 0.048* 0.496 0.263–0.935 0.03*
      CRP/albumin ratio 1.35 0.713–2.558 0.356 1.326 0.713–2.465 0.372
      OS, overall survival; RFS, recurrence-free survival; EC, esophageal cancer; IPTW, inverse probability of treatment weighting; PNI, prognostic nutritional index; CRP, C-reactive protein; NLR, neutrophil-to-lymphocyte ratio. * Statistically significant.

      Table 3. 

      Univariate analysis for RFS and OS of advanced EC patients after IPTW

    • Covariants For OS For RFS
      HR 95% CI p value HR 95% CI p value
      pStage Ⅰ
        High versus low PNI 0.41 0.326–51.66 0.274 2.939 0.281–30.74 0.368
      pStage Ⅱ–Ⅳ
        High versus low PNI 0.233 0.125–0.432 0.001* 0.24 0.130–0.440 0.001*
      OS, overall survival; RFS, recurrence-free survival; IPTW, inverse probability of treatment weighting; PNI, prognostic nutritional index. * Statistically significant.

      Table 4. 

      Univariate analysis for OS and RFS between low and high PNI groups after IPTW in different stages

    • For RFS p value For OS p value
      HR 95% CI HR 95% CI
      Age 0.9123 0.498–1.670 0.766 0.924 0.489–1.743 0.807
      pTNM 1.745 1.305–2.334 0.001* 1.757 1.281–2.410 0.001*
      PNI 0.258 0.133–0.498 0.001* 0.292 0.145–0.588 0.001*
      CRPmax 2.432 1.226–4.823 0.01* 2.079 1.010–4.282 0.047*
      Blood loss 1.92 1.001–3.683 0.049* 2.264 1.116–4.589 0.023*
      OS, overall survival; RFS, recurrence-free survival; EC, esophageal cancer; PNI, prognostic nutritional index; CRP, C-reactive protein. * Statistically significant.

      Table 5. 

      Multivariate Cox analysis for RFS and OS in EC patients

    • Complications Incidence, n/N (%)
      Anastomotic leakages 9/111 (8.1)
      Recurrent nerve palsy 11/111 (9.9)
      Pneumonia 17/111 (19.9)
      Pleural effusion 8/111 (7.2)
      SSI 12/111 (10.71)
      Others 5/111 (4.5)
      Others: chylothorax, ileus, peritonitis (2 patients), and abdominal abscess. Duplicate cases were included. SSI, surgical site infection.

      Table 6. 

      Postoperative complications in this study, Clavien-Dindo ≥2