PT  - JOURNAL ARTICLE
AU  - Zhang, Haowen
AU  - Xiao, Xin
AU  - Luan, Siyuan
AU  - Li, Xiaokun
AU  - Sun, Shangwei
AU  - Yuan, Yong
TI  - Impact of change in the Naples prognostic score after neoadjuvant chemoradiotherapy on survival in esophageal squamous cell carcinoma patients
AID  - 10.15537/smj.2024.45.5.20230908
DP  - 2024 May 01
TA  - Saudi Medical Journal
PG  - 481--489
VI  - 45
IP  - 5
4099  - http://smj.org.sa/content/45/5/481.short
4100  - http://smj.org.sa/content/45/5/481.full
SO  - Saudi Med J2024 May 01; 45
AB  - Objectives: To assess the clinical relevance and prognostic value of changes in the Naples prognostic score (NPS) after neoadjuvant chemoradiotherapy (NACR) among esophageal squamous cell carcinoma (ESCC) patients.Methods: We studied 232 locally advanced ESCC patients who received NACR before undergoing esophagectomy retrospectively. Categorizing individuals into the elevated NPS group and the non-elevated NPS group based on the change in NPS after NACR (ΔNPS > 0 or ∆NPS ≤ 0), we examined and compared the clinicopathological characteristics, survival rates, and postoperative complications between these 2 groups (∆NPS = post-NACR NPS - pre-NACR NPS).Results: Results: Out of the 232 patients enrolled, 105 exhibited elevated NPS levels, while 127 showed non-elevated NPS levels. Survival analyses indicated inferior overall survival (OS) (p=0.024) and recurrence-free survival (RFS) (p=0.047) in the elevated NPS cohort compared to the non-elevated NPS cohort. Subsequent cox regression analyses identified the post-NACR change in NPS as an independent prognostic indicator for RFS (p=0.029) and OS (p=0.036).Conclusion: Elevated NPS post-NACR emerged as a significant indicator of worse prognosis for locally advanced ESCC patients who underwent NACR. This finding has great potential to be useful for recognizing high-risk ESCC patients who received NACR before undergoing esophagectomy and making individualized subsequent therapeutic decisions in clinical practice.