Prognostic Value of CEA and CA 19.9 in Gastric Cancer

Abstract

Introduction: Gastric cancer (GC) is still a major health problem due to the majority of patients present with advanced disease. This considerably reduces the possibility of curative treatment. A critical decision in the treatment of GC is related to staging, which is mainly assessed by the use of the TNM classification. There are other factors that can influence in the prognosis during the preoperative period: pathological type, degree of differentiation or tumor markers level. The most commonly used tumor markers (TM) in GC are CEA and CA 19.9. The aim of the present study is to analyze the relationship between CEA and CA 19.9 markers with certain characteristics of the patients and tumors and to evaluate the utility of these TM determined at the time of diagnosis as prognostic factors.

Material and methods: A prospective collection of the data of all pacients operated by GC at our centre. A total of 501 cases were diagnosed. Mean age was 68.2 years. We analyzed age, sex, tumor location, clinical stage, tumor markers determined in the preoperative period, the use of perioperative chemotherapy and response to chemotherapy, the pathological characteristics and disease follow-up.

Results: At the time of diagnosis 23,3 % of the patients presented high values of CEA, 32,6 % presented high values of CA 19.9 and 14,1% presented with both elevated markers. Patients who were diagnosed at an advanced stage and presented high levels of CEA or CA 19.9 or both TM had worse survival compared to those with normal values.

Conclusion: the presence of an elevated serum level of tumor markers is related to advanced tumor stage and worse prognosis in terms of overall survival.