Abstract

BackgroundElevated 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).MethodsThis 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.ResultsThe 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.ConclusionPreoperatively elevated MCV is an independent prognostic factor for patients with adenocarcinomas of the esophagus and the gastroesophageal junction.

Highlights

  • Elevated mean corpuscular volume (MCV) is associated with a diminished prognosis for various tumor entities

  • We evaluated the prognostic value of preoperative MCV for patients with resectable adenocarcinomas of the esophagus and the gastroesophageal junction as well as the influence of preoperative systemic treatment on the potential prognostic value of MCV

  • The exclusion criteria ruled out distant metastasis at the time of surgery, positive resection margin, postoperative death from a cause other than cancer or death within 30 days after surgery, known history of alcohol abuse, malignancies other than adenocarcinomas of the esophagogastric junction (AEG), and missing preoperative levels of serum MCV, mean corpuscular hemoglobin (MCH), mail: sebastian.schoppmann@meduniwien.ac.at (MCHC), red cell distribution width (RDW), and Hb

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Summary

Introduction

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). Measured preoperative MCV levels were stratified into quintiles and correlated with patients’ survival and clinicopathologic characteristics. 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. Tumor stage and differentiation, adjuvant chemotherapy, MCV, mean corpuscular hemoglobin (MCH), and mean corpuscular hemoglobin concentration

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