High Mean Corpuscular Volume as a Predictor of Poor Overall Survival in Patients with Esophageal Cancer Receiving Concurrent Chemoradiotherapy

Abstract

Ke-jie Li,1,* Wen-yue Gu,2,* Xiao-fang Xia,1 Ping Zhang,3 Chang-lin Zou,3 Zheng-hua Fei3 1Department of Radiation Oncology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, 325000, People’s Republic of China; 2Department of Pathology, Yancheng Hospital Affiliated of Southeast University, Yancheng, Jiangsu 224000, People’s Republic of China; 3Radiation and Medical Oncology Department, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou 325000, People’s Republic of China*These authors contributed equally to this workCorrespondence: Chang-lin Zou; Zheng-hua FeiDepartment of Radiation Oncology, The First Affiliated Hospital of Wenzhou Medical University, No. 2 Fuxue Lane, Wenzhou 325000, People’s Republic of ChinaTel [phone]; [phone]Fax [phone]Email [email protected]; [email protected]: Increasing numbers of recent studies have demonstrated that high mean corpuscular volume (MCV) is a predictor of poor overall survival (OS) and therapeutic response in patients with solid tumors. The aim of the present study was to explore the association between high MCV and OS in patients with advanced esophageal cancer (EC) undergoing concurrent chemoradiotherapy.Patients and Methods: Enrolled in this study were 249 patients with advanced EC who underwent concurrent chemoradiotherapy. Pre-treatment MCV values were collected in all patients and their correlations with OS and pathophysiological characteristics were analyzed. The chi-square test was used to explore the correlation between MCV and various clinical pathophysiological characteristics, and the prognostic significance of high MCV using Kaplan–Meier curves and the Cox proportional hazards model. All P-values were two-tailed and a P-value < 0.05 was considered statistically significant.Results: According to ROC curve analysis, the optimal cut-off value of MCV was 93.6 fL. The mean OS was 14.7 months in all 249 EC patients, 10.9 months in patients with MCV > 93.6 fL, and 18.8 months in patients with MCV < 93.6 fL; the difference is statistically significant (P< 0.05). Chi-square test showed that the MCV value was correlated with the N stage of the tumor and the therapeutic effect, indicating that the higher the MCV was, the higher the T stage of the tumor and the worse the therapeutic effect would be (p=0.012 and p < 0.01). Multivariate analysis showed that MCV (OR = 1.864, 95% CI: 1.439– 2.415) was an independent prognostic factor for OS in EC patients.Conclusion: High MCV is a poor predictor of OS in patients with advanced EC receiving concurrent chemoradiotherapy.Keywords: esophageal cancer, mean corpuscular volume, concurrent chemoradiotherapy, predictors, overall survival

Keywords

• esophageal cancer
• mean corpuscular volume
• concurrent chemoradiotherapy
• predictors
• overall survival