Skip to main content

Advertisement

SpringerLink
Log in

Prognostic significance of preoperative low serum creatine kinase levels in gastric cancer

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

We evaluated the clinicopathological and prognostic significance of preoperative serum creatine kinase (CK) levels in gastric cancer.

Patients and methods

The subjects of this retrospective study were 942 patients who underwent surgery without preoperative chemotherapy for gastric cancer (643 men and 299 women), excluding Stage IV gastric cancer, between January, 2001 and December, 2020. We set the cutoff values for CK according to gender, as 64 U/L for men and 57 U/L for women, and evaluated the clinicopathological, prognostic, and gender significance of low CK levels by multivariate analysis.

Results

Tumor depth was significantly associated with low serum CK levels (p < 0.001). The low CK group showed significantly worse overall survival than the high CK group (p = 0.01). The prognostic impact of low CK levels was evident only in men (p = 0.009). In women, low CK levels were not an independent risk factor for poor prognosis (p = 0.33). These prognostic impacts of low CK levels on overall survival and recurrence-free survival were similar.

Conclusion

Low preoperative CK levels in men with gastric cancer were predictive of poor survival. These prognostic impacts of low CK levels were not evident in women.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. GBD 2017 Stomach Cancer Collaborators. The global, regional, and national burden of stomach cancer in 195 countries, 1990–2017: a systematic analysis for the Global Burden of Disease study. Lancet Gastroenterol Hepatol. 2020;5:42–54.

    Article  Google Scholar 

  2. Global Burden of Disease Cancer Collaboration, Fitzmaurice C, Akinyemiju TF, Al Lami FH, Alam T, Alizadeh NR, et al. Global, regional, and national cancer incidence, mortality, years of life lost, years lived with disability, and disability-adjusted life-years for 29 cancer groups, 1990 to 2016 a systematic analysis for the global burden of disease study. JAMA. 2018;4:1553–68.

    Google Scholar 

  3. Shimada H, Tamaki N, Ohashi M, Oba K, Takahashi Y. Clinical significance of serum tumor markers for gastric cancer: a systematic review of literature by the Task Force of the Japanese Gastric Cancer Association. Gastric Cancer. 2014;17:26–33.

    Article  CAS  Google Scholar 

  4. Suzuki T, Shimada H, Nanami T, Oshima Y, Yajima S, Ito M, et al. Hyperfibrinogenemia is associated with inflammatory mediators and poor prognosis in patients with gastric cancer. Surg Today. 2016;46:1394–401.

    Article  CAS  Google Scholar 

  5. Shimada H, Takiguchi N, Kainuma H, Soda H, Ikeda A, Cho A, et al. High preoperative neutrophil-lymphocyte ratio predicts poor survival in patients with gastric cancer. Gastric Cancer. 2010;13:170–6.

    Article  Google Scholar 

  6. Oshima Y, Suzuki T, Yajima S, Nanami T, Shiratori F, Funahashi K, et al. Serum p53 antibody: useful for detecting gastric cancer but not for predicting prognosis after surgery. Surg Today. 2020;50:1402–8.

    Article  CAS  Google Scholar 

  7. Ito M, Oshima Y, Yajima S, Suzuki T, Nanami T, Shimada H, et al. Is high serum programmed death ligand 1 level a risk factor for poor survival in patients with gastric cancer? Ann Gastroenterol Surg. 2018;2:313–8.

    Article  Google Scholar 

  8. Yan YB. Creatine kinase in cell cycle regulation and cancer. Amino Acids. 2016;48:1775–84.

    Article  CAS  Google Scholar 

  9. Kazak L, Cohen P. Creatine metabolism: energy homeostasis, immunity and cancer biology. Nat Rev Endocrinol. 2020;16:421–36.

    Article  Google Scholar 

  10. Liu L, He Y, Li L, Ge G, Zhou P, Zhu Y, et al. Lactate dehydrogenase and creatine kinase as poor prognostic factors in lung cancer: a retrospective observational study. PLoS ONE. 2017. https://doi.org/10.1371/journal.pone.0182168.

    Article  PubMed  PubMed Central  Google Scholar 

  11. Takamori S, Toyokawa G, Shimokawa M, Kinoshita F, Kozuma Y, Matsubara T, et al. A novel prognostic marker in patients with non-small cell lung cancer: musculo-immuno-nutritional score calculated by controlling nutritional status and creatine kinase. J Thorac Dis. 2019;11:927–35.

    Article  Google Scholar 

  12. Murayama K, Suzuki T, Yajima S, Oshima Y, Nanami T, Shiratori F, Shimada H. Preoperative low serum creatine kinase is associated with poor overall survival in the male patients with esophageal squamous cell carcinoma. Esophagus. 2021. https://doi.org/10.1007/s10388-021-00866-6.

    Article  PubMed  Google Scholar 

  13. Neal RC, Ferdinand KC, Ycas J, Miller E. Relationship of ethnic origin, gender, and age to blood creatine kinase levels. Am J Med. 2009. https://doi.org/10.1016/j.amjmed.2008.08.033.

    Article  PubMed  Google Scholar 

  14. Garcia W. Elevated Creatine phosphokinase levels. Associated with large muscle mass. Another pitfall in evaluating clinical of total serum CPK activity. JAMA. 1974;228:1395–6.

    Article  CAS  Google Scholar 

  15. Japanese Gastric Cancer Association. Japanese Classification of Gastric carcinoma: 3rd English edition. Gastric Cancer. 2011;14:101–12.

    Article  Google Scholar 

  16. Kanda Y. Investigation of the freely available easy-to-use software ‘EZR’ formedical statistics. Bone Marrow Transplant. 2013;48:452–8.

    Article  CAS  Google Scholar 

  17. Hackney AC, Kallman AC, Aggon E. Female sex hormones and the recovery from: menstrual cycle phase affects responses. Biomed Hum Kinet. 2019;11:87–9.

    Article  Google Scholar 

  18. Kurita N, Kamitani T, Wada O, Shintani A, Mizuno K. disentangling associations between serum muscle biomarkers and sarcopenia in the presence of pain and inflammation among patients with osteoarthritis: the SPSS-OK study. J Clin Rheumatol. 2021;27:56–63.

    Article  Google Scholar 

  19. Okubo K, Arigami T, Matsushita D, Kijima T, Shimonosono M, Uesono Y, et al. Clinical impact of creatine phosphokinase and c-reactive protein as predictors of postgastrectomy complications in patients with gastric cancer. BMC Cancer. 2021. https://doi.org/10.1186/s12885-021-07801-z.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We thank Seiko Otsuka for preparing the ethical documents.

Author information

Authors and Affiliations

  1. Department of Clinical Oncology, Graduate School of Medicine, Toho University, Tokyo, Japan

    Nobuto Yamazaki, Yoko Oshima, Fumiaki Shiratori & Hideaki Shimada

  2. Department of Gastrointestinal Surgery, Toho University Medical Center Omori Hospital, Tokyo, Japan

    Nobuto Yamazaki, Yoko Oshima, Fumiaki Shiratori, Tatsuki Nanami, Takashi Suzuki, Satoshi Yajima, Kimihiko Funahashi & Hideaki Shimada

  3. Department of Gastroenterological Surgery and Clinical Oncology, Graduate School of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 142-8541, Japan

    Hideaki Shimada

Authors
  1. Nobuto Yamazaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoko Oshima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fumiaki Shiratori
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Tatsuki Nanami
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Takashi Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Satoshi Yajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kimihiko Funahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hideaki Shimada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hideaki Shimada.

Ethics declarations

Conflict of interest

Hideaki Shimada received research grants and technical lecture fees from Ono Pharmaceutical Co., Ltd.; Taiho Pharmaceutical Co., Ltd.; and Chugai Pharmaceutical Co., Ltd. The other authors declare that they have no conflicts of interest.

Ethical approval

This retrospective study was approved by the Institutional Ethics Committee of Toho University Omori Medical Center (Tokyo, Japan; #M20200 20196 19056 18002).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

595_2022_2505_MOESM1_ESM.pdf

Supplementary file1 Supplemental Fig. 1 Receiver operating characteristic curve of serum CK levels for all patients by gender. (a), Male patients (n = 643). (b), Female patients (n = 299) (PDF 42 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Yamazaki, N., Oshima, Y., Shiratori, F. et al. Prognostic significance of preoperative low serum creatine kinase levels in gastric cancer. Surg Today 52, 1551–1559 (2022). https://doi.org/10.1007/s00595-022-02505-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-022-02505-8

Keywords

Search

Navigation