title: High level of preoperative carbohydrate antigen 19-9 is a poor survival predictor in gastric cancer.
abstract: OBJECTIVE
  To assess the clinical significance and the prognostic value of preoperative serum carbohydrate antigen 19-9 (CA 19-9) level in gastric cancer.
  
  
  METHODS
  Between January 2005 and December 2006, 1960 patients underwent surgery for histologically confirmed gastric cancer. Of these, 163 patients had elevated serum levels of CA 19-9 preoperatively, and 1628 patients had normal serum levels of CA 19-9 preoperatively. For this study, 325 patients were selected from the group of 1628 patients by age, sex, and cancer stage to serve as controls. Statistically significant differences in survival rates were calculated using the log-rank test. A P value less than 0.05 was considered statistically significant and was determined using SAS software.
  
  
  RESULTS
  The baseline characteristics showed some differences between the two groups with regard to histology. Overall survival (OS) in the elevated and non-elevated group was 37.90 and 68.67 mo, respectively (P < 0.001). N stage (P = 0.001) was a significant predictor of disease-free survival by multivariate analysis. Also, N stage (P < 0.001), and the presence of peritoneal metastasis (P < 0.001) remained independent factors in predicting OS by multivariate analysis. Additionally, preoperative serum CA 19-9 levels were significantly associated with OS in univariate (P = 0.009) and multivariate (P = 0.021) analyses.
  
  
  CONCLUSIONS
  Serum CA 19-9 can be considered an independent prognostic factor in predicting OS in patients anticipating surgery for gastric cancer.
authors: Department of Internal Medicine and Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 120-752, South Korea.
authors: A Ra
authors: AR
authors: Choi
authors: Jun Chul
authors: JC
authors: Park
authors: Jie-Hyun
authors: JH
authors: Kim
authors: Sung Kwan
authors: SK
authors: Shin
authors: Sang Kil
authors: SK
authors: Lee
authors: Yong Chan
authors: YC
authors: Lee
authors: Jae Bock
authors: JB
authors: Chung
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018395:CA-19-9 Antigen / Q000032:analysis*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000097:blood / Q000276:immunology* / Q000401:mortality / Q000601:surgery; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D018395:CA-19-9 Antigen
keywords: Carbohydrate antigen 19-9; Disease-free survival; Gastric cancer; Overall survival
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