Prognostic value of early postoperative tumor marker response in gastric cancer

Dong Hyuk Nam, Yong Kang Lee, Jun Chul Park, Hyuk Lee, Sung Kwan Shin, Sang Kil Lee, Yong Chan Lee, Jae Ho Cheong, Woo Jin Hyung, Sung Hoon Noh, Choong Bai Kim

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Background: The clinical usefulness of tumor markers as predictors of treatment outcome in patients with stomach cancer after radical gastrectomy has been poorly defined. The purpose of this study was to evaluate a comprehensive understanding of the impact of early postoperative tumor marker normalization on survival after gastrectomy. Methods: Between January 2001 and December 2007, we enrolled 206 patients who had received radical gastrectomy as an initial treatment and had elevated carcinoembryonic antigen (CEA) (>5 ng/mL) or carbohydrate antigen (CA) 19-9 (>37 U/mL) levels. Early tumor marker response was defined as a normalization of preoperative CEA or CA19-9 values 1-2 months after gastrectomy. Results: The mean patient age was 61 years (range 29-84 years), and 139 patients (67.5 %) were male. Early tumor marker response was identified in 150 of 206 (72.8 %) patients. Of the patients, 49 (23.8 %), 41 (19.9 %), and 116 (56.4 %) were stages I, II, and III, respectively, according to the seventh edition of the American Joint Commission on Cancer (AJCC) staging system. Both disease-free survival (DFS) and overall survival (OS) were significantly longer in patients with tumor marker response compared with nonresponse (61.5 vs. 37.6 months; P = 0.010 and 71.3 vs. 50.9 months; P = 0.008, respectively). Multivariate analyses showed that high CA19-9 level, early tumor marker response, and tumor, node, metastasis classification system stage were independent predictors of DFS and OS (P < 0.05). Conclusions: Early CEA or CA19-9 normalization after radical gastrectomy is a strong prognostic factor for gastric cancer, especially in patients with high preoperative levels of tumor markers.

Original languageEnglish
Pages (from-to)3905-3911
Number of pages7
JournalAnnals of surgical oncology
Volume20
Issue number12
DOIs
Publication statusPublished - 2013 Nov 1

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Tumor Biomarkers
Stomach Neoplasms
Gastrectomy
Carcinoembryonic Antigen
Disease-Free Survival
Survival
Neoplasm Staging
Multivariate Analysis
Joints
Carbohydrates
Neoplasm Metastasis
Antigens
Neoplasms

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Nam, Dong Hyuk ; Lee, Yong Kang ; Park, Jun Chul ; Lee, Hyuk ; Shin, Sung Kwan ; Lee, Sang Kil ; Lee, Yong Chan ; Cheong, Jae Ho ; Hyung, Woo Jin ; Noh, Sung Hoon ; Kim, Choong Bai. / Prognostic value of early postoperative tumor marker response in gastric cancer. In: Annals of surgical oncology. 2013 ; Vol. 20, No. 12. pp. 3905-3911.
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title = "Prognostic value of early postoperative tumor marker response in gastric cancer",
abstract = "Background: The clinical usefulness of tumor markers as predictors of treatment outcome in patients with stomach cancer after radical gastrectomy has been poorly defined. The purpose of this study was to evaluate a comprehensive understanding of the impact of early postoperative tumor marker normalization on survival after gastrectomy. Methods: Between January 2001 and December 2007, we enrolled 206 patients who had received radical gastrectomy as an initial treatment and had elevated carcinoembryonic antigen (CEA) (>5 ng/mL) or carbohydrate antigen (CA) 19-9 (>37 U/mL) levels. Early tumor marker response was defined as a normalization of preoperative CEA or CA19-9 values 1-2 months after gastrectomy. Results: The mean patient age was 61 years (range 29-84 years), and 139 patients (67.5 {\%}) were male. Early tumor marker response was identified in 150 of 206 (72.8 {\%}) patients. Of the patients, 49 (23.8 {\%}), 41 (19.9 {\%}), and 116 (56.4 {\%}) were stages I, II, and III, respectively, according to the seventh edition of the American Joint Commission on Cancer (AJCC) staging system. Both disease-free survival (DFS) and overall survival (OS) were significantly longer in patients with tumor marker response compared with nonresponse (61.5 vs. 37.6 months; P = 0.010 and 71.3 vs. 50.9 months; P = 0.008, respectively). Multivariate analyses showed that high CA19-9 level, early tumor marker response, and tumor, node, metastasis classification system stage were independent predictors of DFS and OS (P < 0.05). Conclusions: Early CEA or CA19-9 normalization after radical gastrectomy is a strong prognostic factor for gastric cancer, especially in patients with high preoperative levels of tumor markers.",
author = "Nam, {Dong Hyuk} and Lee, {Yong Kang} and Park, {Jun Chul} and Hyuk Lee and Shin, {Sung Kwan} and Lee, {Sang Kil} and Lee, {Yong Chan} and Cheong, {Jae Ho} and Hyung, {Woo Jin} and Noh, {Sung Hoon} and Kim, {Choong Bai}",
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doi = "10.1245/s10434-013-3066-7",
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Nam, DH, Lee, YK, Park, JC, Lee, H, Shin, SK, Lee, SK, Lee, YC, Cheong, JH, Hyung, WJ, Noh, SH & Kim, CB 2013, 'Prognostic value of early postoperative tumor marker response in gastric cancer', Annals of surgical oncology, vol. 20, no. 12, pp. 3905-3911. https://doi.org/10.1245/s10434-013-3066-7

Prognostic value of early postoperative tumor marker response in gastric cancer. / Nam, Dong Hyuk; Lee, Yong Kang; Park, Jun Chul; Lee, Hyuk; Shin, Sung Kwan; Lee, Sang Kil; Lee, Yong Chan; Cheong, Jae Ho; Hyung, Woo Jin; Noh, Sung Hoon; Kim, Choong Bai.

In: Annals of surgical oncology, Vol. 20, No. 12, 01.11.2013, p. 3905-3911.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Prognostic value of early postoperative tumor marker response in gastric cancer

AU - Nam, Dong Hyuk

AU - Lee, Yong Kang

AU - Park, Jun Chul

AU - Lee, Hyuk

AU - Shin, Sung Kwan

AU - Lee, Sang Kil

AU - Lee, Yong Chan

AU - Cheong, Jae Ho

AU - Hyung, Woo Jin

AU - Noh, Sung Hoon

AU - Kim, Choong Bai

PY - 2013/11/1

Y1 - 2013/11/1

N2 - Background: The clinical usefulness of tumor markers as predictors of treatment outcome in patients with stomach cancer after radical gastrectomy has been poorly defined. The purpose of this study was to evaluate a comprehensive understanding of the impact of early postoperative tumor marker normalization on survival after gastrectomy. Methods: Between January 2001 and December 2007, we enrolled 206 patients who had received radical gastrectomy as an initial treatment and had elevated carcinoembryonic antigen (CEA) (>5 ng/mL) or carbohydrate antigen (CA) 19-9 (>37 U/mL) levels. Early tumor marker response was defined as a normalization of preoperative CEA or CA19-9 values 1-2 months after gastrectomy. Results: The mean patient age was 61 years (range 29-84 years), and 139 patients (67.5 %) were male. Early tumor marker response was identified in 150 of 206 (72.8 %) patients. Of the patients, 49 (23.8 %), 41 (19.9 %), and 116 (56.4 %) were stages I, II, and III, respectively, according to the seventh edition of the American Joint Commission on Cancer (AJCC) staging system. Both disease-free survival (DFS) and overall survival (OS) were significantly longer in patients with tumor marker response compared with nonresponse (61.5 vs. 37.6 months; P = 0.010 and 71.3 vs. 50.9 months; P = 0.008, respectively). Multivariate analyses showed that high CA19-9 level, early tumor marker response, and tumor, node, metastasis classification system stage were independent predictors of DFS and OS (P < 0.05). Conclusions: Early CEA or CA19-9 normalization after radical gastrectomy is a strong prognostic factor for gastric cancer, especially in patients with high preoperative levels of tumor markers.

AB - Background: The clinical usefulness of tumor markers as predictors of treatment outcome in patients with stomach cancer after radical gastrectomy has been poorly defined. The purpose of this study was to evaluate a comprehensive understanding of the impact of early postoperative tumor marker normalization on survival after gastrectomy. Methods: Between January 2001 and December 2007, we enrolled 206 patients who had received radical gastrectomy as an initial treatment and had elevated carcinoembryonic antigen (CEA) (>5 ng/mL) or carbohydrate antigen (CA) 19-9 (>37 U/mL) levels. Early tumor marker response was defined as a normalization of preoperative CEA or CA19-9 values 1-2 months after gastrectomy. Results: The mean patient age was 61 years (range 29-84 years), and 139 patients (67.5 %) were male. Early tumor marker response was identified in 150 of 206 (72.8 %) patients. Of the patients, 49 (23.8 %), 41 (19.9 %), and 116 (56.4 %) were stages I, II, and III, respectively, according to the seventh edition of the American Joint Commission on Cancer (AJCC) staging system. Both disease-free survival (DFS) and overall survival (OS) were significantly longer in patients with tumor marker response compared with nonresponse (61.5 vs. 37.6 months; P = 0.010 and 71.3 vs. 50.9 months; P = 0.008, respectively). Multivariate analyses showed that high CA19-9 level, early tumor marker response, and tumor, node, metastasis classification system stage were independent predictors of DFS and OS (P < 0.05). Conclusions: Early CEA or CA19-9 normalization after radical gastrectomy is a strong prognostic factor for gastric cancer, especially in patients with high preoperative levels of tumor markers.

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U2 - 10.1245/s10434-013-3066-7

DO - 10.1245/s10434-013-3066-7

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JO - Annals of Surgical Oncology

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