Preoperative BChE serves as a prognostic marker in patients with resectable AEG after neoadjuvant chemotherapy.

Autor: Gensthaler L; Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria., Jomrich G; Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria., Brugger J; Section for Medical Statistics (IMS), Center of Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria., Kollmann D; Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria., Paireder M; Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria., Bologheanu M; Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria., Horn A; Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria., Riegler FM; Reflux Ordination, Mariannengasse 10/4/9, 1090, Vienna, Austria., Asari R; Division of Visceral Surgery, Department of General Surgery, Comprehensive Cancer Center Vienna, Upper GI-Service, Medical University of Vienna, Spitalgasse 23, 1090, Vienna, Austria., Schoppmann SF; 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.schoppmann@meduniwien.ac.at.; Department of General Surgery, Medical University of Vienna, Waehringer Guertel 18-20, 1090, Vienna, Austria. sebastian.schoppmann@meduniwien.ac.at.
Jazyk: angličtina
Zdroj: Langenbeck's archives of surgery [Langenbecks Arch Surg] 2023 Jun 06; Vol. 408 (1), pp. 227. Date of Electronic Publication: 2023 Jun 06.
DOI: 10.1007/s00423-023-02938-w
Abstrakt: 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.
(© 2023. The Author(s).)
Databáze: MEDLINE
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