Prognostic significance of serum alkaline phosphatase and lactate dehydrogenase levels in patients with unresectable advanced gastric cancer

Tsutomu Namikawa, Nobuko Ishida, Sachi Tsuda, Kazune Fujisawa, Eri Munekage, Jun Iwabu, Masaya Munekage, Sunao Uemura, Shigehiro Tsujii, Takahiko Tamura, Tomoaki Yatabe, Hiromichi Maeda, Hiroyuki Kitagawa, Michiya Kobayashi, Kazuhiro Hanazaki

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Abstract

Background: This study evaluated the prognostic value of alkaline phosphatase (ALP) and lactate dehydrogenase (LDH) together with host-related factors in patients with unresectable advanced gastric cancer. Methods: The study enrolled 262 patients who received chemotherapy for unresectable advanced gastric cancer at Kochi Medical School from 2007 to 2015. Clinicopathological information and systemic inflammatory response data were analyzed for associations between baseline cancer-related prognostic variables and survival outcomes. Results: The median survival time was significantly lower for patients with high ALP, high LDH, high total bilirubin, high aspartate aminotransferase, high alanine transaminase, high gamma-glutamyltransferase, high creatinine, a Glasgow prognostic score (GPS) of 1 or 2 score compared to GPS 0, higher compared to lower neutrophil to lymphocyte ratio (NLR) 3.9, lower compared to higher prognostic nutrition index 36.1, T3–4 compared to T1–2 tumor and diffuse-type compared to intestinal-type histology. Multivariate survival analysis identified high ALP 322 (HR 1.808; 95% CI 1.015–3.220; P = 0.044), T2–3 (HR 2.622; 95% CI 1.224–5.618; P = 0.013), and diffuse-type gastric cancer (HR 2.325; 95% CI 1.341–4.032; P = 0.003) as significant independent predictors of worse prognosis in the studied group of cancer patients. Conclusions: High level of ALP is an independent, worse prognosis factor for patients receiving chemotherapy for unresectable and recurrent gastric cancer.

Original languageEnglish
Pages (from-to)684-691
Number of pages8
JournalGastric Cancer
Volume22
Issue number4
DOIs
Publication statusPublished - 12-07-2019

All Science Journal Classification (ASJC) codes

  • Oncology
  • Gastroenterology
  • Cancer Research

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    Namikawa, T., Ishida, N., Tsuda, S., Fujisawa, K., Munekage, E., Iwabu, J., Munekage, M., Uemura, S., Tsujii, S., Tamura, T., Yatabe, T., Maeda, H., Kitagawa, H., Kobayashi, M., & Hanazaki, K. (2019). Prognostic significance of serum alkaline phosphatase and lactate dehydrogenase levels in patients with unresectable advanced gastric cancer. Gastric Cancer, 22(4), 684-691. https://doi.org/10.1007/s10120-018-0897-8