Prognostic value of pre-operative serum uric acid levels in esophageal squamous cell carcinoma patients who undergo R0 esophagectomy

Article type: Research Article

Authors: Chen, You-Fang^a | Li, Qiang^a | Chen, Dong-Tai^a | Pan, Jia-Hao^a | Chen, Yong-Hua^a | Wen, Zhe-Sheng^{b; *} | Zeng, Wei-An^{a; *}

Affiliations: [a] Department of Anesthesiology, Cancer Center, Sun Yat-Sen University, State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China | [b] Department of Thoracic Oncology, Cancer Center, Sun Yat-Sen University, State Key Laboratory of Oncology in South China, Guangzhou, Guangdong, China

Correspondence: [*] Corresponding author: Wei-An Zeng, Department of Anesthesiology, Cancer Center, Sun Yat-Sen University, No. 651, Dongfeng Road East, Guangzhou, Guangdong 510060, China. Tel.: +86 20 8734 3062; Fax: +86 20 8734 3062; E-mail: zengwa@mail.sysu. edu.cn; Zhe-Sheng Wen, Department of Thoracic Oncology, Cancer Center, Sun Yat-Sen University, No. 651, Dongfeng Road East, Guangzhou, Guangdong 510060, China. Tel.: +86 20 8734 3314, Fax: +86 20 8734 3171, E-mail: wenzhsh@sysucc.org.cn

Abstract: BACKGROUND: The serum uric acid (SUA) is the end-product from the metabolic breakdown of purine nucleotides. It has been considered to be a prognostic factor for malignant tumor in several researches. However, its prognostic value in patients with esophageal squamous cell carcinoma (ESCC) has not been elucidated. METHODS: We retrospectively reviewed the records of 209 ESCC patients who underwent R0 esophagectomy. A receiver operating characteristic (ROC) curve analysis was used to determine the optimal cut-off value for pre-operative SUA levels and to divide the ESCC patients into two groups. Furthermore, we analyzed the pre-operative serum uric acid (SUA) levels and its relationship with the clinicopathological parameters and the prognosis of 209 ESCC patients. RESULTS: Optimal cut-off value for pre-operative SUA in ROC analysis was 304.5 μ mol/l (sensitivity 67.46%, specificity 65.06%). SUA low- or high-levels were associated with gender (P< 0.001), smoking status (P< 0.001), pN statues (P= 0.003) and TNM stage (P= 0.010). SUA levels, tumor differentiation and pTNM stage were independent predictors of ESCC patient survival in a multivariate analysis. CONCLUSIONS: The pre-operative level of SUA is an independent prognostic predictor in ESCC patients who undergo R0 esophagectomy and patients with higher SUA level may have an unfavorable survival probability.

Keywords: Esophageal squamous cell carcinoma, SUA, overall survival, disease-free survival, prognostic factor

DOI: 10.3233/CBM-160621

Journal: Cancer Biomarkers, vol. 17, no. 1, pp. 89-96, 2016