Skip to main content
SpringerLink
Log in

Prognostic impact of CEA/CA19-9 at the time of recurrence in patients with gastric cancer

  • Original Article
  • Published:
Surgery Today Aims and scope Submit manuscript

Abstract

Purpose

We evaluated the clinical impact of the carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) values at the time of recurrence in gastric cancer patients.

Methods

Among 790 patients with R0 resected gastric cancer without neoadjuvant therapy between 2004 and 2017, 89 recurrence cases were retrospectively evaluated. The clinical impact of CEA and CA19-9 values on recurrence sites and post-recurrent prognosis were evaluated using univariate and multivariate analyses.

Results

The positive rates of CEA and CA19-9 at recurrence were significantly higher than the preoperative positive rates (CEA, 56% vs 24%; CA19-9, 37% vs 15%). Although CA19-9-positive patients at recurrence exhibited a poor survival, the difference was not significant. The positive rates of CEA at liver or lymph node recurrence were significantly higher than the preoperative positive rates. The positive rate of CA19-9 at peritoneal recurrence was significantly higher than the preoperative positive rate. CA19-9-positive patients at recurrence exhibited worse prognosis than CA19-9-negative patients, although the difference was not significant. At lymph node recurrence, CA19-9-positive patients exhibited a significantly worse survival than CA19-9-negative patients.

Conclusion

In recurrent gastric cancer, the positive status of CA19-9 at recurrence might have a negative prognostic impact after recurrence; particularly, in patients with lymph node recurrence.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7

Similar content being viewed by others

References

  1. Van Cutsem E, Sagaert X, Topal B, Haustermans K, Prenen H. Gastric cancer. Lancet. 2016;388:2654–64.

    Article  Google Scholar 

  2. Oshima Y, Suzuki T, Yajima S, Nanami T, Shiratori F, Funahashi K, et al. Serum p53 antibody: useful for detecting gastric cancer but not for predicting prognosis after surgery. Surg Today. 2020;50:1402–8.

    Article  CAS  Google Scholar 

  3. Ito M, Oshima Y, Yajima S, Suzuki T, Nanami T, Shiratori F, et al. Diagnostic impact of high serum midkine level in patients with gastric cancer. Ann Gastroenterol Surg. 2019;3:195–201.

    Article  Google Scholar 

  4. Hoshino I, Nabeya Y, Takiguchi N, Gunji H, Ishige F, Iwatate Y, et al. Prognostic impact of p53 and/or NY-ESO-1 autoantibody induction in patients with gastroenterological cancers. Ann Gastroenterol Surg. 2020;4:275–82.

    Article  Google Scholar 

  5. Shimada H, Noie T, Ohashi M, Oba K, Takahashi Y. Clinical significance of serum tumor markers for gastric cancer: a systematic review of literature by the task force of the Japanese gastric cancer association. Gastric Cancer. 2014;17:26–33.

    Article  CAS  Google Scholar 

  6. Suenaga Y, Kanda M, Ito S, Mochizuki Y, Teramoto H, Ishigure K, et al. Prognostic significance of perioperative tumor marker levels in stage II/III gastric cancer. World J Gastrointest Oncol. 2019;11:17–27.

    Article  Google Scholar 

  7. Uda H, Kanda M, Tanaka C, Kobayashi D, Inaoka K, Tanaka Y, et al. Perioperative serum carcinoembryonic antigen levels predict recurrence and survival of patients with pathological T2–4 gastric cancer treated with curative gastrectomy. Dig Surg. 2018;35:55–63.

    Article  CAS  Google Scholar 

  8. Wang W, Chen XL, Zhao SY, Xu YH, Zhang WH, Liu K, et al. Prognostic significance of preoperative serum CA125, CA19-9 and CEA in gastric carcinoma. Oncotarget. 2016;7:35423–36.

    Article  Google Scholar 

  9. Liu X, Qiu H, Liu J, Chen S, Xu D, Li W, et al. Combined preoperative concentrations of CEA, CA 19-9, and 72-4 for predicting outcomes in patients with gastric cancer after curative resection. Oncotarget. 2016;7:35446–53.

    Article  Google Scholar 

  10. Takahashi Y, Takeuchi T, Sakamoto J, Touge T, Mai M, Ohkura H, et al. The usefulness of CEA and/or CA19-9 in monitoring for recurrence in gastric cancer patients: a prospective clinical study. Gastric Cancer. 2003;6:142–5.

    Article  Google Scholar 

  11. Komatsu S, Ichikawa D, Nishimura Y, Kubota T, Okamoto K, Shiozaki A, et al. Better outcomes by monitoring tumour dynamics using sensitive tumour markers in patients with recurrent gastric cancer. Anticancer Res. 2013;33:1621–7.

    PubMed  Google Scholar 

  12. Kanda Y. Investigation of the freely available easy-to-use software “EZR” for medical statistics. Bone Marrow Transplant. 2013;48:452–8.

    Article  CAS  Google Scholar 

  13. Feng F, Tian Y, Xu G, Liu Z, Liu S, Zheng G, et al. Diagnostic and prognostic value of CEA, CA19-9, AFP and CA125 for early gastric cancer. BMC Cancer. 2017;17:737.

    Article  Google Scholar 

  14. Lee EC, Yang JY, Lee KG, Oh SY, Suh YS, Kong SH, et al. The value of postoperative serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels for the early detection of gastric cancer recurrence after curative resection. J Gastric Cancer. 2014;14:221–8.

    Article  CAS  Google Scholar 

  15. Sawayama H, Iwatsuki M, Kuroda D, Toihata T, Uchihara T, Koga Y, et al. The association of the lymph node ratio and serum carbohydrate antigen 19-9 with early recurrence after curative gastrectomy for gastric cancer. Surg Today. 2018;48:994–1003.

    Article  CAS  Google Scholar 

  16. Wada N, Kurokawa Y, Miyazaki Y, Makino T, Takahashi T, Yamasaki M, et al. The characteristics of the serum carcinoembryonic antigen and carbohydrate antigen 19-9 levels in gastric cancer cases. Surg Today. 2017;47:227–32.

    Article  CAS  Google Scholar 

  17. Wu F, Shi C, Wu R, Huang Z, Chen Q. Peritoneal recurrence in gastric cancer following curative resection can be predicted by postoperative but not preoperative biomarkers: a single-institution study of 320 cases. Oncotarget. 2017;8:78120–32.

    Article  Google Scholar 

  18. Zhou YC, Zhao HJ, Shen LZ. Preoperative serum CEA and CA19-9 in gastric cancer–a single tertiary hospital study of 1075 cases. Asian Pac J Cancer Prev. 2015;16:2685–91.

    Article  Google Scholar 

  19. Ushigome M, Shimada H, Miura Y, Yoshida K, Kaneko T, Koda T, et al. Changing pattern of tumor markers in recurrent colorectal cancer patients before surgery to recurrence: serum p53 antibodies, CA19-9 and CEA. Int J Clin Oncol. 2020;25:622–32.

    Article  CAS  Google Scholar 

  20. Song YX, Huang XZ, Gao P, Sun JX, Chen XW, Yang YC, et al. Clinicopathologic and prognostic value of serum carbohydrate antigen 19-9 in gastric cancer: a meta-analysis. Dis Markers. 2015;2015:549843.

    PubMed  PubMed Central  Google Scholar 

  21. Kotzev AI, Draganov PV. Carbohydrate antigen 19-9, carcinoembryonic antigen, and carbohydrate antigen 72-4 in gastric cancer: is the old band still playing? Gastrointest Tumors. 2018;5:1–13.

    Article  CAS  Google Scholar 

  22. Bebnowska D, Grywalska E, Niedzwiedzka-Rystwej P, Sosnowska-Pasiarska B, Smok-Kalwat J, Pasiarski M, et al. CAR-T cell therapy-an overview of targets in gastric cancer. J Clin Med. 2020;9:1894.

    Article  CAS  Google Scholar 

Download references

Acknowledgements

The authors would like to thank MARUZEN-YUSHODO Co., Ltd. (https://kw.maruzen.co.jp/kousei-honyaku/) for the English language editing.

Author information

Authors and Affiliations

  1. Department of Clinical Oncology, Toho University Graduate School of Medicine, Ota-ku, Tokyo, Japan

    Jin Moriyama & Hideaki Shimada

  2. Department of Surgery, Toho University School of Medicine, Ota-ku, Tokyo, Japan

    Yoko Oshima, Tatsuki Nanami, Takashi Suzuki, Satoshi Yajima, Fumiaki Shiratori, Kimihiko Funahashi & Hideaki Shimada

  3. Department of Gastroenterological Surgery and Clinical Oncology, Graduate School of Medicine, Toho University, 6-11-1 Omori-Nishi, Ota-ku, Tokyo, 143-8541, Japan

    Hideaki Shimada

Authors
  1. Jin Moriyama
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Yoko Oshima
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Tatsuki Nanami
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Takashi Suzuki
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Satoshi Yajima
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Fumiaki Shiratori
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Kimihiko Funahashi
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Hideaki Shimada
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Hideaki Shimada.

Ethics declarations

Conflict of interest

Jin Moriyama and the coauthors declare no conflicts of interest.

Ethical approval

The ethical statement of this retrospective study was approved by the Ethics Committee of Faculty of Medicine, Toho University and the Ethics Committee of Toho University Omori Medical Center (Tokyo, Japan; A16035_A16001_26095_25024_24038_22047, M20196 19056 18002).

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Moriyama, J., Oshima, Y., Nanami, T. et al. Prognostic impact of CEA/CA19-9 at the time of recurrence in patients with gastric cancer. Surg Today 51, 1638–1648 (2021). https://doi.org/10.1007/s00595-021-02248-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00595-021-02248-y

Keywords

Search

Navigation