Preoperative NRI Outperforms Other Timepoints in Predicting Prognosis of ESCC with Neoadjuvant Therapy

Xue TangMei Yang^*

• West China School of Medicine, West China Hospital, Sichuan University, Chengdu, China

Background: Early studies reported that nutritional risk index (NRI) was a prognostic factor in patients with a variety of malignant tumors. Our study aims to demonstrate the prognostic role of NRI through assessing the longitudinal clinical data in patients with ESCC who had undergone neoadjuvant therapy followed by esophagectomy.: Our study retrospectively investigated 319 ESCC patients who had been treated with neoadjuvant therapy before esophagectomy at West China Hospital, Sichuan University from August 2016 to August 2021, the NRI was calculated based on the height, weight, and albumin level of ESCC patients at three time points during the whole treatment course: before treatment, before esophagectomy and post-esophagectomy.Results: 319 patients with ESCC were finally included in our study. The logistic regression showed that ESCC patients with low preoperative NRI had a higher postoperative complication rate compared with those patients with high preoperative NRI (OR=2.324, 1.318-4.095, P=0.004). The timing point of malnutrition which affected survival most was the preoperative NRI score. According to the multivariate analysis results, the preoperative NRI rather than pretreatment NRI or postoperative NRI was an independent prognostic factor for OS (HR=2. 005, 1.070-3.760, P=0.030) and DFS (HR=1.736, 1.086-2.775, P=0.021) in patients with ESCC.In patients with ESCC who underwent neoadjuvant therapy followed by 3 esophagectomy, preoperative NRI might predict postoperative complications and the survival outcomes of patients. More clinical investigation to detect the prognostic value of NRI is warranted.