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Prognostic Factors of Toyokawa et al for a Patient with Resectable Thoracic Esophageal Squamous Cell Carcinoma

Description

Toyokawa et al identified prognostic factors for a patient with an esophageal squamous cell carcinoma. These include a nutritional assessment using a simple screen for nutritional status called the CONUT (CONtrolling NUTritional status). The authors are from Osaka City University and Osaka City General Hospital in Japan.


Patient selection: resectable thoracic esophageal squamous cell carcinoma

 

Outcome: 5-year overall survival

 

Parameters from multivariate analysis:

(1) gender

(2) ECOG performance status (over range from 0 to 2)

(3) ASA classification

(4) clinical TNM stage

(5) CONUT score of nutritional status (from 0 to 12)

 

Parameter

Finding

Points

gender

female

0

 

male

1

performance status

ECOG 0

0

 

ECOG >= 1

1

ASA class

ASA 1 or 2

0

 

ASA 3+

1

TNM stage

I or II

0

 

III to IV

1

CONUT score

0 to 2 (good nutrition)

0

 

>= 3

1

 

where:

• A clinical TNM stage II had a p value of 0.16 and hazard ratio of 1.5, which places it in limbo.

• A stage IV cancer does not sound resectable.

 

number of poor prognostic factors =

= SUM(points for all 5 parameters)

 

Interpretation:

• minimum score: 0

• maximum score: 5

• The higher the score the worse the 5-year overall survival.


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