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The prognosis of gastric cancer patients with marginally elevated carcinoembryonic antigen (CEA) values after D2 radical gastrectomy

Authors

  • Shi Chen MD,

    1. Department of Gastropancreatic Surgery, Sun Yat-Sen University Cancer Center, Guangdong, PR China
    2. State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangdong, PR China
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  • Xing-Yu Feng MD,

    1. Department of Gastropancreatic Surgery, Sun Yat-Sen University Cancer Center, Guangdong, PR China
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  • Yuan-Fang Li MD,

    1. Department of Gastropancreatic Surgery, Sun Yat-Sen University Cancer Center, Guangdong, PR China
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  • Bai-Wei Zhao MD,

    1. Department of Gastropancreatic Surgery, Sun Yat-Sen University Cancer Center, Guangdong, PR China
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  • Zhi-Wei Zhou MD, PhD,

    1. Department of Gastropancreatic Surgery, Sun Yat-Sen University Cancer Center, Guangdong, PR China
    2. State Key Laboratory of Oncology in South China, Sun Yat-Sen University Cancer Center, Guangdong, PR China
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  • Ying-Bo Chen MD

    Corresponding author
    1. Department of Gastropancreatic Surgery, Sun Yat-Sen University Cancer Center, Guangdong, PR China
    • Department of Gastropancreatic Surgery, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, Guangdong 510060, PR China. Fax: +86-20-87343625.===

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  • Conflict of interest: There are no financial disclosures from any authors.

Abstract

Aim

To investigate the clinical significance of the postoperative serum carcinoembryonic antigen (CEA) levels in gastric cancer patients who underwent D2 radical gastrectomy and to identify the prognostic factors for patients with marginally elevated postoperative CEA levels.

Methods

We performed a retrospective study of 480 patients who were histologically diagnosed with gastric cancer and who underwent D2 radical surgery at the Sun Yat-sen University Cancer Center between January 2004 and December 2009. The follow-up lasted until June 2011. Chi-squared tests and Kaplan–Meier methods were employed to compare the adverse events and prognoses.

Results

In this group of gastric cancer patients, the postoperative serum CEA level (P = 0.002) was an independent prognostic factor; the same was true for the histological T and N staging (P < 0.001 and P = 0.045, respectively). In the group of marginally elevated postoperative CEA level gastric cancer patients, univariate analysis demonstrated that tumor position (P = 0.042); histological grade (P = 0.002); and Boarrmann type (P = 0.003) were significant prognostic factors. Multivariate analysis showed that the tumor position (P = 0.003) and histological grade (P = 0.007) were independent prognostic factors for these patients.

Conclusion

Our study showed that patients with normal postoperative CEA levels have a better prognosis. Furthermore, for marginally elevated postoperative CEA level gastric cancer patients, the tumor position and histological grade were two important factors for predicting the prognosis and the need for aggressive therapy. J. Surg. Oncol. 2013;107:641–645. © 2013 Wiley Periodicals, Inc.

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