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- Title
Prognostic significance of pre- and post-operative tumour markers for patients with gastric cancer.
- Authors
Lin, Jun-Peng; Lin, Jian-Xian; Ma, Yu-Bin; Xie, Jian-Wei; Yan, Su; Wang, Jia-Bin; Lu, Jun; Chen, Qi-Yue; Ma, Xin-Fu; Cao, Long-Long; Lin, Mi; Tu, Ru-Hong; Zheng, Chao-Hui; Li, Ping; Huang, Chang-Ming
- Abstract
<bold>Background: </bold>In clinical practice, carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 are the most common markers measured before and after surgery for gastric cancer (GC). However, which pre- or post-operative combined tumour markers (CEA and CA19-9) have more prognostic value remains unclear.<bold>Methods: </bold>Consecutive patients undergoing a resection for GC at the Fujian Medical University Union Hospital were included as a discovery database between January 2011 and December 2014. The prognostic impact of pre- and post-operative tumour markers was evaluated using Kaplan-Meier log-rank survival analysis and multivariable Cox regression analysis. The results were then externally validated.<bold>Results: </bold>A total of 735 and 400 patients were identified in the discovery cohort and in the validation cohort, respectively. Overall survival rates decreased in a stepwise manner in association with the number of pre- and post-operative positive tumour markers (both P < 0.001). Multivariable analysis revealed that the number of pre-operative positive tumour markers was an independent prognostic factor (P < 0.05). For patients with abnormal pre-operative tumour markers, normalisation of tumour markers after surgery is an independent prognostic protective factor (hazard ratio (HR) = 0.618; 95% confidence interval (CI) = 0.414-0.921), and patients with both positive post-operative tumour markers had double the risk of overall death (HR = 2.338; 95% CI = 1.071-5.101). Similar results were observed in the internal validation and external validation cohorts.<bold>Conclusion: </bold>Pre-operative tumour markers have a better discriminatory ability for post-operative survival in GC patients than post-operative tumour markers, and the normalisation of tumour markers after surgery was associated with better survival.
- Subjects
STOMACH tumors; RESEARCH; PREOPERATIVE period; RESEARCH methodology; PROGNOSIS; RETROSPECTIVE studies; MEDICAL cooperation; EVALUATION research; GASTRECTOMY; COMPARATIVE studies; KAPLAN-Meier estimator; POSTOPERATIVE period; TUMOR antigens; PROPORTIONAL hazards models
- Publication
British Journal of Cancer, 2020, Vol 123, Issue 3, p418
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-020-0901-z