title: Serum CA 19-9 as a prognostic factor in patients with metastatic gastric cancer.
abstract: OBJECTIVE
  To evaluate tumor markers as prognostic factors in patients with metastatic or recurrent gastric cancer receiving first-line chemotherapy.
  
  
  METHODS
  Between January 2000 and December 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Oncology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Jae-Cheol
authors.initials: JC
authors.lastname: Jo
authors.forename: Min-Hee
authors.initials: MH
authors.lastname: Ryu
authors.forename: Dong-Hoe
authors.initials: DH
authors.lastname: Koo
authors.forename: Baek-Yeol
authors.initials: BY
authors.lastname: Ryoo
authors.forename: Hwa Jung
authors.initials: HJ
authors.lastname: Kim
authors.forename: Tae Won
authors.initials: TW
authors.lastname: Kim
authors.forename: Kee Don
authors.initials: KD
authors.lastname: Choi
authors.forename: Gin Hyug
authors.initials: GH
authors.lastname: Lee
authors.forename: Hwoon-Yong
authors.initials: HY
authors.lastname: Jung
authors.forename: Jeong Hwan
authors.initials: JH
authors.lastname: Yook
authors.forename: Sung Tae
authors.initials: ST
authors.lastname: Oh
authors.forename: Byung Sik
authors.initials: BS
authors.lastname: Kim
authors.forename: Jin-Ho
authors.initials: JH
authors.lastname: Kim
authors.forename: Yoon-Koo
authors.initials: YK
authors.lastname: Kang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018395:CA-19-9 Antigen / Q000097:blood*; D006801:Humans; D008875:Middle Aged; D009362:Neoplasm Metastasis; D011379:Prognosis; D013274:Stomach Neoplasms / Q000097:blood* / Q000473:pathology*; D055815:Young Adult
chemical_list: D018395:CA-19-9 Antigen