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Gastric Cancer

, Volume 22, Issue 4, pp 684–691 | Cite as

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

  • Tsutomu NamikawaEmail author
  • 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
Original Article
  • 278 Downloads

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.

Keywords

Alkaline phosphatase Lactate dehydrogenase Gastric cancer Prognostic value Survival 

Notes

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Copyright information

© The International Gastric Cancer Association and The Japanese Gastric Cancer Association 2018

Authors and Affiliations

  • Tsutomu Namikawa
    • 1
    Email author
  • Nobuko Ishida
    • 1
  • Sachi Tsuda
    • 1
  • Kazune Fujisawa
    • 1
  • Eri Munekage
    • 1
  • Jun Iwabu
    • 1
  • Masaya Munekage
    • 1
  • Sunao Uemura
    • 1
  • Shigehiro Tsujii
    • 1
  • Takahiko Tamura
    • 2
  • Tomoaki Yatabe
    • 2
  • Hiromichi Maeda
    • 3
  • Hiroyuki Kitagawa
    • 1
  • Michiya Kobayashi
    • 3
    • 4
  • Kazuhiro Hanazaki
    • 1
  1. 1.Department of SurgeryKochi Medical SchoolNankokuJapan
  2. 2.Department of Anesthesiology and Intensive Care MedicineKochi Medical SchoolKochiJapan
  3. 3.Cancer Treatment CenterKochi Medical School HospitalKochiJapan
  4. 4.Department of Human Health and Medical SciencesKochi Medical SchoolKochiJapan

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