Prognostic value of postoperative CA19-9 normalization in patients with advanced gastric cancer.

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.