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Gensthaler L, Jomrich G, Brugger J, Kollmann D, Paireder M, Bologheanu M, Horn A, Riegler FM, Asari R, Schoppmann SF. Preoperative BChE serves as a prognostic marker in patients with resectable AEG after neoadjuvant chemotherapy. Langenbecks Arch Surg 2023; 408:227. [PMID: 37280384 PMCID: PMC10244274 DOI: 10.1007/s00423-023-02938-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Accepted: 05/12/2023] [Indexed: 06/08/2023]
Abstract
BACKGROUND Diminished systemic serum butyrylcholinesterase (BChE), a biomarker for chronic inflammation, cachexia, and advanced tumor stage, has shown to play a prognostic role in various malignancies. The aim of this study was to investigate the prognostic value of pretherapeutic BChE levels in patients with resectable adenocarcinoma of the gastroesophageal junction (AEG), treated with or without neoadjuvant therapy. METHODS Data of a consecutive series of patients with resectable AEG at the Department for General Surgery, Medical University of Vienna, were analyzed. Preoperative serum BChE levels were correlated to clinic-pathological parameters as well as treatment response. The prognostic impact of serum BChE levels on disease-free (DFS) and overall survival (OS) was evaluated by univariate and multivariate cox regression analysis, and Kaplan-Meier curves used for illustration. RESULTS A total of 319 patients were included in this study, with an overall mean (standard deviation, SD) pretreatment serum BChE level of 6.22 (± 1.91) IU/L. In univariate models, diminished preoperative serum BChE levels were significantly associated with shorter overall (OS, p < 0.003) and disease-free survival (DFS, p < 0.001) in patients who received neoadjuvant treatment and/or primary resection. In multivariated analysis, decreased BChE was significantly associated with shorter DFS (HR: 0.92, 95% CI: 0.84-1.00, p 0.049) and OS (HR: 0.92, 95% CI: 0.85-1.00, p < 0.49) in patients receiving neoadjuvant therapy. Backward regression identified the interaction between preoperative BChE and neoadjuvant chemotherapy as a predictive factor for DFS and OS. CONCLUSION Diminished serum BChE serves as a strong, independent, and cost-effective prognostic biomarker for worse outcome in patients with resectable AEG who had received neoadjuvant chemotherapy.
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Affiliation(s)
- Lisa Gensthaler
- Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Gerd Jomrich
- Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Jonas Brugger
- Section for Medical Statistics (IMS), Center of Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Dagmar Kollmann
- Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Matthias Paireder
- Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Milena Bologheanu
- Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Alexander Horn
- Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Franz M Riegler
- Reflux Ordination, Mariannengasse 10/4/9, 1090, Vienna, Austria
| | - Reza Asari
- Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria
| | - Sebastian F Schoppmann
- Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria.
- Department of General Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria.
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Liu CT, Hong CQ, Huang XC, Li EM, Xu YW, Peng YH. Blood-based Markers in the Prognostic Prediction of Esophagogastric Junction Cancer. J Cancer 2020; 11:4332-4342. [PMID: 32489452 PMCID: PMC7255356 DOI: 10.7150/jca.44545] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 04/13/2020] [Indexed: 02/05/2023] Open
Abstract
Esophagogastric junction cancer poses a great threat to human beings both in western countries and East Asia, especially in China and Japan, and its incidence has increased during recent decades. The 5-year survival rate of esophagogastric junction cancer is quite poor compared with that of other gastric cancer sites. Until now, the traditional TNM staging system has been widely used in clinical practice for prognosis. However, the TNM system is based on pathology after surgical resection or radiology using CT and MRI, not on blood markers. Evidently, some research has been reported concentrated on the prognostic value of blood-based markers with the character of non-invasive and non-radioactive in EJA. Hematologic, biochemical and coagulation parameters could be obtained from clinical data and utilized to analyze their prognostic values. Tumor-associated antigens, microRNAs and circulating tumor cells have also been reported in EJC prognosis. In this article, we review research focused on blood-based markers to evaluate their prognostic value in esophagogastric junction cancer, especially its main subtype adenocarcinoma.
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Affiliation(s)
- Can-Tong Liu
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Chao-Qun Hong
- Department of Oncological Laboratory Research, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
| | - Xu-Chun Huang
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - En-Min Li
- Department of Biochemistry and Molecular Biology, Shantou University Medical College, Shantou, Guangdong, China
| | - Yi-Wei Xu
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Yu-Hui Peng
- Department of Clinical Laboratory Medicine, the Cancer Hospital of Shantou University Medical College, Shantou, Guangdong, China
- Precision Medicine Research Center, Shantou University Medical College, Shantou, Guangdong, China
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Jomrich G, Hollenstein M, John M, Ristl R, Paireder M, Kristo I, Asari R, Schoppmann SF. High Mean Corpuscular Volume Predicts Poor Outcome for Patients With Gastroesophageal Adenocarcinoma. Ann Surg Oncol 2019; 26:976-985. [PMID: 30706229 PMCID: PMC6399169 DOI: 10.1245/s10434-019-07186-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2018] [Indexed: 02/06/2023]
Abstract
BACKGROUND Elevated mean corpuscular volume (MCV) is associated with a diminished prognosis for various tumor entities. This study aimed to evaluate the association between preoperative serum MCV levels and both overall (OS) and disease-free survival (DFS) for patients with resectable adenocarcinomas of the esophagogastric junction (AEG). METHODS This study included consecutive patients undergoing surgical resection between 1992 and 2016. Measured preoperative MCV levels were stratified into quintiles and correlated with patients' survival and clinicopathologic characteristics. RESULTS The study analyzed 314 patients with a median OS of 36.8 months and a median DFS of 20.6 months. The multivariate analysis showed that preoperatively elevated MCV is a significant prognostic factor for OS (hazard ratio [HR], 1.05; 95% confidence interval [CI], 1.03-1.08; P < 0.001) and DFS (HR, 1.05; 95% CI, 1.03-1.08; P < 0.001). In the subgroup analysis of neoadjuvantly treated and untreated patients, MCV remained an independent prognostic factor for OS (HR, 1.08; 95% CI, 1.04-1.12; P < 0.001) and DFS (HR, 1.07; 95% CI, 1.03-1.12; P < 0.001) in both groups. In the univariate analysis, tumor stage and differentiation, adjuvant chemotherapy, MCV, mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration (MCHC) were significantly correlated with diminished OS and DFS. CONCLUSION Preoperatively elevated MCV is an independent prognostic factor for patients with adenocarcinomas of the esophagus and the gastroesophageal junction.
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Affiliation(s)
- Gerd Jomrich
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), Vienna, Austria
| | - Marlene Hollenstein
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), Vienna, Austria
| | - Max John
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), Vienna, Austria
| | - Robin Ristl
- Section for Medical Statistics (IMS), Center of Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Matthias Paireder
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), Vienna, Austria
| | - Ivan Kristo
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), Vienna, Austria
| | - Reza Asari
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), Vienna, Austria
| | - Sebastian F Schoppmann
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), Vienna, Austria.
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Jomrich G, Hollenstein M, John M, Baierl A, Paireder M, Kristo I, Ilhan-Mutlu A, Asari R, Preusser M, Schoppmann SF. The modified glasgow prognostic score is an independent prognostic indicator in neoadjuvantly treated adenocarcinoma of the esophagogastric junction. Oncotarget 2018; 9:6968-6976. [PMID: 29467943 PMCID: PMC5805529 DOI: 10.18632/oncotarget.24087] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 01/02/2018] [Indexed: 12/19/2022] Open
Abstract
The modified Glasgow Prognostic Score (mGPS) combines the indicators of decreased plasma albumin and elevated CRP. In a number of malignancies, elevated mGPS is associated with poor survival. Aim of this study was to investigate the prognostic role of mGPS in patients with neoadjuvantly treated adenocarcinomas of the esophagogastric junction 256 patients from a prospective database undergoing surgical resection after neoadjuvant treatment between 2003 and 2014 were evaluated. mGPS was scored as 0, 1, or 2 based on CRP (>1.0 mg/dl) and albumin (<35 g/L) from blood samples taken prior (preNT-mGPS) and after (postNT-mGPS) neoadjuvant therapy. Scores were correlated with clinicopathological patients’ characteristics. From 155 Patients, sufficient data was available. Median follow-up was 63.8 months (33.3–89.5 months). In univariate analysis, Cox proportional hazard model shows significant shorter patients OS (p = 0.04) and DFS (p = 0.02) for increased postNT-mGPS, preNT-hypoalbuminemia (OS: p = 0.003; DFS: p = 0.002) and post-NT-CRP (OS: p = 0.03; DFS: p = 0.04). Elevated postNT-mGPS and preNT-hypoalbuminemia remained significant prognostic factors in multivariate analysis for OS (p = 0.02; p = 0.005,) and DFS (p = 0.02, p = 0.004) with tumor differentiation and tumor staging as significant covariates. PostNT-mGPS and preNT-hypoalbuminemia are independent prognostic indicators in patients with neoadjuvantly treated adenocarcinomas of the esophagogastric junction and significantly associated with diminished OS and DFS.
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Affiliation(s)
- Gerd Jomrich
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), 1090 Vienna, Austria
| | - Marlene Hollenstein
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), 1090 Vienna, Austria
| | - Maximilian John
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), 1090 Vienna, Austria
| | - Andreas Baierl
- Department of Statistics and Operations Research, University of Vienna, 1090 Vienna, Austria
| | - Matthias Paireder
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), 1090 Vienna, Austria
| | - Ivan Kristo
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), 1090 Vienna, Austria
| | - Aysegül Ilhan-Mutlu
- Department of Medicine 1, Medical University of Vienna, Comprehensive Cancer Center (CCC), 1090 Vienna, Austria
| | - Reza Asari
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), 1090 Vienna, Austria
| | - Matthias Preusser
- Department of Medicine 1, Medical University of Vienna, Comprehensive Cancer Center (CCC), 1090 Vienna, Austria
| | - Sebastian F Schoppmann
- Department of Surgery, Medical University of Vienna, and Gastroesophageal Tumor Unit, Comprehensive Cancer Center (CCC), 1090 Vienna, Austria
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Al-Sukhni E, Gabriel E, Attwood K, Kukar M, Nurkin SJ, Hochwald SN. No Survival Difference with Neoadjuvant Chemoradiotherapy Compared with Chemotherapy in Resectable Esophageal and Gastroesophageal Junction Adenocarcinoma: Results from the National Cancer Data Base. J Am Coll Surg 2016; 223:784-792.e1. [DOI: 10.1016/j.jamcollsurg.2016.09.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Revised: 08/31/2016] [Accepted: 09/01/2016] [Indexed: 12/28/2022]
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