ASSOCIATION BETWEEN PREOPERATIVE PLASMA CEA LEVELS AND THE PROGNOSIS OF GASTRIC-CANCER FOLLOWING CURATIVE RESECTION

A large-scale retrospective study was undertaken to evaluate the assoc iation between preoperative plasma carcinoembryonic antigen (CEA) leve ls and the prognosis of 2768 gastric cancer patients who underwent cur ative gastrectomy between 1983 and 1984 at 66 leading medical institut ions in Japan. Postoperative follow-up was at least 5 years. Preoperat ive plasma CEA levels were also analysed against other prognostic fact ors. Preoperative plasma CEA levels showed strong correlations to the degree of lymph node metastasis (P < 0.001), TNM stage (P = 0.004) and the histopathology of the gastric cancer (P < 0.001). Preoperative CE A levels were also evaluated against survival, after being adjusted fo r the effect of clinically important factors by multivariate analysis. Patients with lower preoperative plasma CEA levels survived significa ntly longer than patients with higher CEA levels (P < 0.0001). This an alysis demonstrates that curatively resected gastric cancer patients w ith higher preoperative plasma CEA levels have a poorer prognosis than those with lower levels, despite the adjustment for the effects of ma jor prognostic factors.