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The impact of low serum cholinesterase levels on survival in patients with colorectal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Nutritional and inflammatory status have been associated with postoperative recurrence and poor survival in patients with colorectal cancer. The aim of the present study is to investigate the relationship between serum cholinesterase levels and postoperative outcomes among patients who underwent curative resection for colorectal cancer.

Methods

The study comprised 174 patients who had undergone curative resection for colorectal cancer. We explored the relationship between preoperative serum cholinesterase levels and disease-free survival and overall survival after curative resection. Then patients were divided into the high-cholinesterase group (n = 102) and the low-cholinesterase group (n = 72) to analyze their clinicopathological variables including other nutritional markers and systemic inflammatory responses.

Results

In multivariate analysis, lymph node metastasis (P = 0.011) and serum cholinesterase levels (P < 0.01) were independent predictors of disease-free survival, while lymph node metastasis (P = 0.013), serum cholinesterase levels (P < 0.01), and carbohydrate antigen19-9 (P = 0.022) were independent predictors of overall survival. In the low-cholinesterase group, neutrophil to lymphocyte ratio, (P = 0.021), C-reactive protein to albumin ratio (P < 0.01), and distant metastasis (P < 0.01) were higher, and prognostic nutritional index (P < 0.01) was lower compared with the high-cholinesterase group.

Conclusion

Preoperative low serum cholinesterase levels can be a prognostic factor for postoperative recurrence and poor prognosis in patients after curative resection for colorectal cancer, suggesting an important role of cholinesterase in the assessment of nutritional and inflammatory status in cancer patients.

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Availability of data and material

The datasets analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

ASA-PS:

American Society of Anesthesiologists physical status

BMI:

Body mass index

CAR:

C-reactive protein to albumin ratio

CA19-9:

Carbohydrate antigen 19–9

CEA:

Carcinoembryonic antigen

ChE:

Cholinesterase

CRC:

Colorectal cancer

NLR:

Neutrophil to lymphocyte ratio

N.S.:

Not significant

PNI:

Prognostic nutritional index

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Author information

Authors and Affiliations

  1. Department of Surgery, Tokyo General Hospital, Tokyo, Japan

    Yasuhiro Takano, Shu Tsukihara, Daisuke Ito, Hironori Kanno, Kyonsu Son & Nobuyoshi Hanyu

  2. Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo, 105-8461, Japan

    Koichiro Haruki & Ken Eto

Authors
  1. Yasuhiro Takano
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  2. Koichiro Haruki
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  4. Daisuke Ito
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  5. Hironori Kanno
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  7. Nobuyoshi Hanyu
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Contributions

Y. T. and K. H. developed the main concept and designed the study. Y. T., K. H., S. T., D. I., H. K., K. S., N. H., and K. E. were responsible for acquisition of clinicopathological data. Y. T. and K. H. performed data analysis and interpretation. Y. T., K. H., and K. E. drafted the manuscript. K. E. contributed to editing and critical revision for important intellectual contents.

Corresponding author

Correspondence to Koichiro Haruki.

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Ethics approval

The protocol for the present study was approved by the Ethics Committee of Tokyo General Hospital (No. 21–3) and it conforms to the provisions of the Declaration of Helsinki.

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Informed consent was obtained from all individual participants included in the study.

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The authors declare no competing interests.

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Takano, Y., Haruki, K., Tsukihara, S. et al. The impact of low serum cholinesterase levels on survival in patients with colorectal cancer. Int J Colorectal Dis 37, 869–877 (2022). https://doi.org/10.1007/s00384-022-04119-5

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