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Updated: Sep 23, 2025

Gene Regulation and Targeted Therapy in Gastric Cancer Peritoneal Metastasis: Radiological Findings from Dual Energy CT and PET/CT
Published on: January 22, 2018
Preoperative CA19-9 is a prognostic factor in pT3N0 gastric cancer patients undergoing curative resection
Tsunehiko Maruyama1, Yoshimasa Akashi2, Hiroyuki Hakoda3
1Department of Surgery, Mito Saiseikai General Hospital, 3-3-10 Futabadai, Mito, Ibaraki, 311-4198, Japan. t-maru@ya2.so-net.ne.jp.
Background:
The standard treatment for pT3N0 gastric cancer (GC) in Japanese guidelines is radical surgery without adjuvant chemotherapy. However, certain percentages of these patients develop recurrences; therefore, detecting the high-risk subgroup of recurrence may contribute to improve patient's outcome by adjuvant chemotherapy. In this study, we aimed to identify a predictive indicator of poor prognosis in pT3N0 GC.
Methods:
Eighty-one patients who were diagnosed as pT3N0 GC after curative surgical resection and had not received adjuvant chemotherapy were included. The clinicopathological factors and laboratory parameters were evaluated by univariate and multivariate analyses to identify prognostic factors of tumor recurrence. Survival analysis was performed by Kaplan-Meier method.
Results:
Male (P = 0.027), a high body mass index (BMI) (P = 0.031), a high CA19-9 value (P = 0.025), and a lower number of retrieved lymph nodes (P = 0.018) were found to be significantly associated with a shorter recurrence free survival (RFS). In a multivariate analysis, high CA19-9 value (> 37 U/ml) [(hazard ratio (HR): 3.326; 95% confidence interval (CI): 1.044 to 10.596; P = 0.042] was found to be an independent predictor of RFS.
Conclusion:
The preoperative high CA19-9 value is considered a useful prognostic marker for predicting cancer recurrence after curative surgery in pT3N0 GC patients. For those patients, adjuvant chemotherapy might be considered to improve the survival outcome.

