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Prognostic Value of Early Postoperative Tumor Marker Response in Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The clinical usefulness of tumor markers as predictors of treatment outcome in patients with stomach cancer after radical gastrectomy has been poorly defined. The purpose of this study was to evaluate a comprehensive understanding of the impact of early postoperative tumor marker normalization on survival after gastrectomy.

Methods

Between January 2001 and December 2007, we enrolled 206 patients who had received radical gastrectomy as an initial treatment and had elevated carcinoembryonic antigen (CEA) (>5 ng/mL) or carbohydrate antigen (CA) 19-9 (>37 U/mL) levels. Early tumor marker response was defined as a normalization of preoperative CEA or CA19-9 values 1–2 months after gastrectomy.

Results

The mean patient age was 61 years (range 29–84 years), and 139 patients (67.5 %) were male. Early tumor marker response was identified in 150 of 206 (72.8 %) patients. Of the patients, 49 (23.8 %), 41 (19.9 %), and 116 (56.4 %) were stages I, II, and III, respectively, according to the seventh edition of the American Joint Commission on Cancer (AJCC) staging system. Both disease-free survival (DFS) and overall survival (OS) were significantly longer in patients with tumor marker response compared with nonresponse (61.5 vs. 37.6 months; P = 0.010 and 71.3 vs. 50.9 months; P = 0.008, respectively). Multivariate analyses showed that high CA19-9 level, early tumor marker response, and tumor, node, metastasis classification system stage were independent predictors of DFS and OS (P < 0.05).

Conclusions

Early CEA or CA19-9 normalization after radical gastrectomy is a strong prognostic factor for gastric cancer, especially in patients with high preoperative levels of tumor markers.

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Acknowledgment

Supported in part by a faculty research Grant of Yonsei University College of Medicine for 2010 (6-2010-0145).

Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul, Korea

    Dong Hyuk Nam MD, Yong Kang Lee MD, Jun Chul Park MD, Hyuk Lee MD, Sung Kwan Shin MD, Sang Kil Lee MD & Yong Chan Lee MD

  2. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea

    Jae-Ho Cheong MD, Woo Jin Hyung MD, Sung Hoon Noh MD & Choong Bai Kim MD

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  1. Dong Hyuk Nam MD
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  2. Yong Kang Lee MD
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Correspondence to Jun Chul Park MD.

Additional information

Dong Hyuk Nam and Yong Kang Lee have contributed equally to this article, and both should be considered first author.

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Nam, D.H., Lee, Y.K., Park, J.C. et al. Prognostic Value of Early Postoperative Tumor Marker Response in Gastric Cancer. Ann Surg Oncol 20, 3905–3911 (2013). https://doi.org/10.1245/s10434-013-3066-7

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  • DOI: https://doi.org/10.1245/s10434-013-3066-7

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