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Preoperative positivity of serum tumor markers is a strong predictor of hematogenous recurrence of gastric cancer
Author(s) -
Marrelli Daniele,
Pinto Enrico,
De Stefano Alfonso,
de Manzoni Giovanni,
Farnetani Maurizio,
Garosi Lorenzo,
Roviello Franco
Publication year - 2001
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.1163
Subject(s) - medicine , multivariate analysis , incidence (geometry) , univariate analysis , cancer , lymph node , gastroenterology , tumor marker , risk factor , surgery , physics , optics
Background and Objectives Preoperative positivity of serum tumor markers has been reported to be a prognostic factor in several neoplasms. The aim of this longitudinal study was to evaluate the correlation between CEA, CA 19‐9, and CA 72‐4 preoperative serum levels and the site of recurrence after curative surgery for gastric cancer. Methods One hundred sixty‐seven patients resected for primary gastric cancer between January 1988 and June 1996 were considered. All patients were followed‐up according to the same protocol, with a mean follow‐up time of 45 ± 39 months (range: 2–130). The correlation between marker positivity and the incidence of recurrence was studied by means of univariate and multivariate analyses. Results A tumor recurrence was found in 92 patients (55.1%). For each of the three markers, preoperative positivity was related to a higher incidence of hematogenous recurrences with respect to negative cases; univariate analysis also revealed a higher incidence of locoregional recurrences in CA 72‐4‐positive cases. At multivariate analysis, preoperative positivity for one or more tumor markers proved to be an independent predictor of hematogenous recurrences ( P < 0.005, relative risk [RR] 4.82), in addition to lymph node involvement ( P < 0.05, RR 3.82); no correlation between marker positivity and the onset of locoregional or peritoneal recurrences was found. Conclusions Preoperative positivity for CEA, CA 19‐9 or CA 72‐4 is an independent risk factor for hematogenous recurrences of gastric carcinoma; this aspect should be considered in the option of using adjuvant chemotherapy after surgery for gastric cancer. J. Surg. Oncol. 2001;78:253–258. © 2001 Wiley‐Liss, Inc.