title: Normal carcinoembryonic antigen indicates benefit from perioperative chemotherapy to gastric carcinoma patients.
abstract: OBJECTIVE
  To evaluate pretreatment serum carcinoembryonic antigen (CEA) as a predictor of survival for patients with locally advanced gastric cancer receiving perioperative chemotherapy.
  
  
  METHODS
  We retrospectively studied a cohort of 228 gastric cancer patients who underwent D2 gastrectomy combined with chemotherapy at the Sun Yat-sen University Cancer Center between January 2005 and December 2009. Among them, 168 patients received 6-12 cycles of oxaliplatin-based adjuvant (post-operative) chemotherapy, while 60 received perioperative chemotherapy (2 cycles of FOLFOX6 or XELOX before surgery and 4-10 cycles after surgery). Serum CEA was measured using an enzyme immunoassay. The follow-up lasted until December 2010.
  
  
  RESULTS
  In the group that had elevated serum CEA, the difference in survival time between patients receiving perioperative chemotherapy and those receiving adjuvant chemotherapy had no statistical significance (P > 0.05). However, in the group that had normal serum CEA, patients receiving perioperative chemotherapy had a longer survival time. In multivariate analysis, T staging and lymph node metastatic rate were independent prognostic factors for the patients. Perioperative chemotherapy improved the overall survival of patients who had a normal pretreatment CEA level (P = 0.070).
  
  
  CONCLUSIONS
  Normal pretreatment serum CEA is a predictor of survival for patients receiving perioperative chemotherapy.
authors.affiliation: State Key Laboratory of Oncology in South China, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong Province, China.
authors.forename: Shi
authors.initials: S
authors.lastname: Chen
authors.forename: Ying-Bo
authors.initials: YB
authors.lastname: Chen
authors.forename: Yuan-Fang
authors.initials: YF
authors.lastname: Li
authors.forename: Xing-Yu
authors.initials: XY
authors.lastname: Feng
authors.forename: Zhi-Wei
authors.initials: ZW
authors.lastname: Zhou
authors.forename: Xiu-Hong
authors.initials: XH
authors.lastname: Yuan
authors.forename: Chao-Nan
authors.initials: CN
authors.lastname: Qian
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000628:therapy; D000970:Antineoplastic Agents / Q000008:administration & dosage; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015331:Cohort Studies; D003131:Combined Modality Therapy; D006801:Humans; D053208:Kaplan-Meier Estimate; D059035:Perioperative Period; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000097:blood* / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D002272:Carcinoembryonic Antigen