Preoperative Low Serum Calcium Levels Predict Poor Prognosis for Patients with Esophageal Cancer

Abstract

Purpose: Hypercalcemia has been reported as a poor prognostic factor in malignant tumors. However, no report has shown the clinical impact of serum calcium levels on patients with esophageal cancer. We evaluated the prognostic impact of preoperative serum calcium levels on patients with esophageal cancer. Methods: We evaluated 240 patients (197 men, 43 women; mean age, 66 years; age range, 34-85 years) with esophageal cancer who underwent radical surgery between September 2008 and December 2017. After assigning the patients to two groups (high calcium group, 8.8 mg/dL or more and low calcium group, 8.7 mg/dL or less), we compared the groups' overall survival and the clinicopathological features. The clinicopathological and prognostic significance of preoperative serum calcium levels were evaluated in a univariate and multivariate analysis. Results: The patients with deep tumors showed low serum calcium levels significantly more frequently (P <0.05). The low calcium group showed a significantly worse prognosis than the high calcium group (P <0.05). However, low serum calcium level was not an independent poor prognostic factor. Conclusions: Preoperative low serum calcium levels were associated with advanced tumors. Low serum calcium might be associated with esophageal cancer progression.

The effects and predictive value of calcium and magnesium concentrations on nutritional improvement, inflammatory response and diagnosis in patients with Crohn's disease

“…In our study, patients in the active phase had significantly higher levels of inflammatory indicators than those in either the remission or the control group (Tables 1 and 2). Previous studies have shown that magnesium and calcium are effective antagonists of cytokines 9,10,22,26,27 . One possible explanation for these findings is that there may be an interaction between an individual's inflammatory status and his or her magnesium and calcium levels.…”

“…In addition, it has been shown that magnesium may be a sensitive marker for the activity of small bowel disease 25 . Low calcium concentrations are also closely associated with the progression and poor prognosis of oesophageal cancer, which was also a disease of the digestive tract 26 . Taking all these factors into consideration, we propose that magnesium and calcium may be used as auxiliary markers in addition to the existing assessment methods.…”

“…Calcium deficiency also leads to intestinal mucosal damage, increased exudation and an exacerbation of inflammation. The therapeutic effects of calcium on the intestine are well documented 10,22,26,27 . Calcium supplementation can reduce intestinal permeability, reduce exposure of the colonic mucosa to potentially harmful luminal antigens and decrease inflammation 10 .…”

“…27,28 The PG-SGA score focuses on the assessment of chronic nutritional changes, which can effectively compensate for the low sensitivity and short-term changes in the BMI. 27 Although it has been shown that 65%-75% of CD patients are malnourished, 26 fewer studies have investigated the mutual influence of magnesium and calcium on nutritional status. Here, we found that magnesium, calcium and the nutritional status of CD patients were correlated (Table 3), whereas there was a significant positive association between magnesium and calcium concentrations.…”

“…Previous studies have shown that magnesium and calcium are effective antagonists of cytokines. 9,10,22,26,27 One possible explanation for these findings is that there may be an interaction between an individual's inflammatory status and his or her magnesium and calcium levels. These results suggest that the potential roles of calcium and magnesium in the treatment of CD warrant further exploration.…”