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Prognostic value of postoperative CA19-9 normalization in patients with advanced gastric cancer
Oh Kyoung Kwon1, Wansik Yu, Hoyoung Chung
1Gastric Cancer Center, Kyungpook National University Medical Center, Daegu, Korea.
Background/Aims:
CA19-9 is known to have positive correlation with depth of invasion, nodal involvement, and peritoneal metastasis in gastric adenocarcinoma. In patients with high preoperative CA19-9 serum levels who underwent curative gastrectomy, we evaluated the prognostic impact of postoperative normalization of CA 19-9.
Methodology:
Among 1,439 patients who underwent curative gastrectomy for advanced gastric adenocarcinoma, data of 102 patients with advanced gastric adenocarcinoma whose preoperative serum CA19-9 level was higher than cutoff value (37 U/mL) were reviewed. If serum CA19-9 level had fallen below 37 U/mL at 6 months after surgery, the CA19-9 level was considered normalized.
Results:
CA19-9 levels were normalized in 79 patients but not in 23 patients. There were statistically significant differences in prognosis according to depth of invasion, presence of lymph node metastasis, extent of gastric resection, and postoperative CA19-9 normalization on univariate analyses. Multivariate analysis revealed that pathological lymph node metastasis (p<0.001) and postoperative CA19-9 normalization were independent prognostic factors (p=0.001).
Conclusions:
In patients with advanced gastric adenocarcinoma who underwent curative gastric resection, postoperative normalization of CA19-9 can be a surrogate for potentially curative surgical treatment and can be used as a good prognostic factor.
