Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2020 Aug 18:10:1432.
doi: 10.3389/fonc.2020.01432. eCollection 2020.

Prognostic Value of Changes in Preoperative and Postoperative Serum CA19-9 Levels in Gastric Cancer

Xiao-Hai Song  1   2 , Kai Liu  1   2 , Shi-Jie Yang  1   2 , Wei-Han Zhang  1   2 , Xiao-Long Chen  1   2 , Lin-Yong Zhao  1   2 , Xin-Zu Chen  1   2 , Kun Yang  1   2 , Zong-Guang Zhou  1   3 , Jian-Kun Hu  1   2
Affiliations

Prognostic Value of Changes in Preoperative and Postoperative Serum CA19-9 Levels in Gastric Cancer

Xiao-Hai Song et al. Front Oncol. .

Abstract

Objective: The prognostic significance of serum CA19-9 levels in gastric cancer patients remains a matter debate. The aim of this study was to determine the prognostic value of changes in preoperative and postoperative serum CA19-9 levels in patients with gastric cancer. Methods: A total of 1,046 gastric cancer patients who underwent curative gastrectomy in West China Hospital of Sichuan University from January 2011 to December 2016 were analyzed retrospectively. Patients were categorized by minimum P-value using X-tile, while the baseline confounders for CA19-9 changes were balanced through propensity score matching (PSM). The relationships between CA19-9 changes and other clinicopathologic features were measured. Univariate and multivariate analysis were performed to explore the risk factors associated with survival outcomes. Results: We included 653 patients. Changes in CA19-9 levels significantly correlated with age, tumor size, macroscopic type, histological grade, T stage and TNM stage. Kaplan-Meier curves revealed that patients with CA19-9 changes <20% had significant better overall survival than those with changes more than 20% (p < 0.001); Cox regression analysis revealed the CA19-9 change (p = 0.010), gender (p = 0.031), histological grade (p = 0.036) and TNM stage (p < 0.001) were independent risk factors for survival after PSM. Stratification analysis indicated that patients with CA19-9 change more than 20% had worse prognosis that those with CA19-9 change no more than 20% in male (p = 0.002), poorly differentiated or undifferentiated type (p = 0.031) and TNM stage III (p = 0.006). Conclusion: Changes in preoperative and postoperative serum CA19-9 levels were closely associated with clinicopathological traits and was an independent prognostic factor in gastric cancer patients. This parameter may be a reliable marker for prediction of survival.

Keywords: CA19-9; gastrectomy; gastric cancer; overall survival; prognosis.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Kaplan–Meier survival analyses of four subgroups of gastric cancer patients with CA19-9 change.
Figure 2
Figure 2
Kaplan–Meier survival analyses of two subgroups of gastric cancer patients with CA19-9 change before PSM (A) and after PSM (B).
Figure 3
Figure 3
Kaplan–Meier survival analyses of two subgroups of gastric cancer patients with CA19-9 change stratified by TNM stage (A–C), gender (D,E) and histological grade (F,G).
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Chen W, Zheng R, Baade PD, Zhang S, Zeng H, Bray F, et al. Cancer statistics in China, 2015. CA Cancer J Clin. (2016) 66:115–32. 10.3322/caac.21338 - DOI - PubMed
    1. Song X, Liu K, Sun L, Chen X, Zhao L, Zhang W, et al. . Clinicopathological characteristics and prognostic factors of remnant gastric cancer: a single-center retrospective analysis of 90 patients. Int J Surg. (2018) 51:97–103. 10.1016/j.ijsu.2018.01.019 - DOI - PubMed
    1. Wang W, Li YF, Sun XW, Chen YB, Li W, Xu DZ, et al. . Prognosis of 980 patients with gastric cancer after surgical resection. Chin J Cancer. (2010) 29:923–30. 10.5732/cjc.010.10290 - DOI - PubMed
    1. Chen S, Feng XY, Li YF, Zhao BW, Zhou ZW, Chen YB. The prognosis of gastric cancer patients with marginally elevated carcinoembryonic antigen (CEA) values after D2 radical gastrectomy. J Surg Oncol. (2013) 107:641–5. 10.1002/jso.23300 - DOI - PubMed
    1. Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. (2001) 345:725–30. 10.1056/NEJMoa010187 - DOI - PubMed