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Serum CA 19‐9 as a prognostic factor in patients with metastatic gastric cancer
Author(s) -
Jo JaeCheol,
Ryu MinHee,
Koo DongHoe,
Ryoo BaekYeol,
Kim Hwa Jung,
Kim Tae Won,
Choi Kee Don,
Lee Gin Hyug,
Jung HwoonYong,
Yook Jeong Hwan,
Oh Sung Tae,
Kim Byung Sik,
Kim JinHo,
Kang YoonKoo
Publication year - 2013
Publication title -
asia‐pacific journal of clinical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 29
eISSN - 1743-7563
pISSN - 1743-7555
DOI - 10.1111/ajco.12019
Subject(s) - carcinoembryonic antigen , medicine , gastroenterology , univariate analysis , chemotherapy , hazard ratio , cancer , multivariate analysis , oncology , confidence interval
Aim To evaluate tumor markers as prognostic factors in patients with metastatic or recurrent gastric cancer receiving first‐line chemotherapy. Methods Between J anuary 2000 and D ecember 2008, 1178 patients with metastatic or recurrent gastric cancer were assayed for expression of three serum tumor markers, CA 19‐9, CA 72‐4 and carcinoembryonic antigen ( CEA) , prior to the initiation of first‐line chemotherapy. Results Elevated serum concentrations of carbohydrate antigen ( CA) 19‐9 (>37 U / mL ), CA 72‐4 (>4 U / mL ) and carcinoembryonic antigen ( CEA) (>6 ng/ mL ) were observed in 38, 56 and 33% of patients, respectively. Univariate analysis showed that elevated serum concentration of each of the three markers, CA 19‐9 ( P = 0.001), CA 72‐4 ( P = 0.001) and CEA ( P = 0.030), was significantly associated with poor patient prognosis. However, multivariate analysis showed that an elevated CA 19‐9 concentration only was significantly associated with shorter survival (hazard ratio [ HR] 1.22; 95% CI , 1.08–1.37, P = 0.002). In the good risk and moderate risk groups, previously defined by clinical factors alone, survival was significantly lower in patients with elevated CA 19‐9 ( P < 0.001 and P = 0.021, respectively), but this difference was not observed in the poor‐risk group. Conclusion Elevated serum CA 19‐9 concentration in patients with metastatic or recurrent gastric cancer, especially in good or moderate risk groups, is an independent negative predictor of prognosis.