The Clinical Impact of the Naples Prognostic Score in Esophageal Cancer Patients who Receive Curative Treatment

This study aimed to evaluate the clinical impact of the Naples Prognostic Score (NPS) in patients with esophageal cancer and to clarify the potential application of the NPS as a nutritional and inflammation evaluation system. This study included 106 patients who underwent curative treatment for esophageal cancer between 2005 and 2020. The prognosis and clinicopathological parameters of the high-NPS (NPS > 2) and low-NPS (NPS = 0, 1) groups were analyzed. The 3- and 5-year OS rates were 79.5% and 64.8%, respectively, in the NPS-low group and 55.4% and 52.3% in the NPS-high group. There were significant differences between the two groups (P < 0.001). In a multivariate analysis for OS, the NPS was identified as an independent prognostic factor (hazard ratio (HR), 2.220; 95% confidence interval (CI), 1.123-4.389; P = 0.022). Moreover, the 3- and 5-year recurrence-free survival (RFS) rates were 55.8% and 53.0%, respectively, in the NPS-low group and 42.0% and 28.0% in the NPS-high group. A multivariate analysis for RFS identified the NPS as an independent prognostic factor (HR, 1.931; 95% CI, 1.120-3.329; P = 0.018). NPS is one of the factors having an impact on outcome in addition to others, such as T factor or N factor, in patients with EC who received curative treatment. The NPS may be a promising biomarker for the treatment and management of esophageal cancer.