The prognostic significance of preoperative sevum CA 19-9 in patients withresectable gastric carcinoma: Comparison with CEA

Background and Objectives: In this study, the prognostic value of preoperat ive serum levels of tumor markers CA 19-9 and carcinoembryonic antigen (CEA ) in gastric carcinoma which has been a controversial matter was investigat ed. Methods: Preoperative serum CA 19-9 (cut-off value 37 U/ml) and CEA (cut-of f value 5 ng/ml) levels were measured in 168 patients with resectable gastr ic carcinoma. The correlation between tumor marker levels and clinicopathol ogical features and overall survival was studied. Results: CA 19-9 and CEA positivity rates were 31.5 and 17.8% respectively. In CA 19-9 positive patients, the ratio of males, tumors exceeding subsero sa and advanced stage tumors (stages III and IV) was significantly higher ( P = 0.052, P = 0.0005 and P = 0.029, respectively). A weak correlation was found with CA 19-9 positivity and tumor location, however, no correlation e xisted between CA 19-9 positivity and age, tumor size, histologic type, lym ph node, hepatic and peritoneal metastasis. The proportion of tumors extend ing beyond subserosa and with Lymph node metastasis was significantly highe r in CEA positive patients (P = 0.811 and P = 0.045, respectively). No corr elation was found between CEA positivity and gender, age, tumor location, t umor size, and hepatic and peritoneal metastasis: however, a weak correlati on existed between CEA positivity and histologic type and tumor stage. Over all survival was significantly poorer in CA. 19-9 and CEA positive patients (log-rank test, P = 0.014, P = 0.003, respectively). However, the Cos prop ortional hazards regression analysis did not show independent prognostic va lue for both tumor markers. Conclusions: In resectable gastric carcinoma, preoperative serum CA 19-9 an d CEA levels ma indicate stage of the disease, but neither has an independe nt prognostic value. (C) 2001 Wiley-Liss, Inc.