BCHE and gastroesophageal junction adenocarcinoma: Similarly, in patients with resectable adenocarcinoma of the gastroesophageal junction, diminished preoperative butyrylcholinesterase levels were shown to predict inferior disease-free and overall survival following neoadjuvant chemotherapy, further supporting its role as a marker of systemic inflammation and tumor aggressiveness rather than a procedure-specific phenomenon [27].