P-0128 - Prognostic significance of CEA, CA19-9 and CA72-4 serum level before and after preoperative chemotherapy of esophagogastric junction adenocarcinoma
|Date||28 June 2014|
|Event||World GI 2014|
|Topics|| Oesophageal Cancer
|Citation||Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165|
M. Zemanova1, Z. Pechačová1, T. Haruštiak2, P. Fencl3, P. Vítek4
The prognosis of patients with operable esophagogastric junction carcinoma is improved with pre or peri-operative chemotherapy (CT). This benefit is probably limited to a minority of chemosensitive cases. Carbohydrate antigens 19-9 and 72-4 (CA 19-9 and CA72-4) and the carcinoembryonic antigen (CEA) are the most widely used serum-based tumor markers for a diagnosis and follow up of (esophago)gastric adenocarcinoma. The aim of this study is to assess a clinical significance and a prognostic value of preoperative serum CA 19-9, CA 72-4 and CEA levels in esophagogastric junction tumors.
Between February 2008 and September 2013, 142 patients were treated for biopsy confirmed esopagogastric junction adenocarcinoma with preoperative CT. CA 19-9, CA 72-4 and CEA blood levels were measured before treatment start and after end of preoperative CT using standard methodology. Kaplan-Meier survival curves were calculated and plotted. Progression free survival (PFS) were compared between groups using log-rank test. P-values less than 0.05 were considered statistically significant. R Project software was employed in data analyses and testing.
In all 142 patients, median PFS was 14.4 months, 1-year PFS was 59% and 3-year PFS 32% resp. Any baseline marker elevation was found for CEA, CA 19-9 and CA 72-4 in 25%, 44% and 31% patients resp. PFS in the elevated and non-elevated groups was 12.1 month and 15.7 month resp. for CA 19-9 (p = 0.034), differences for CA 72-4 and CEA were not significant. Values measured after preoperative CT were prognostic for CEA (P = 0.02) and for CA 19-9 (p = 0.03) as well, with longer PFS in non-elevated groups. Patients with any decrease of CA 19-9 value from baseline to post-CT measurement had significantly longer PFS as those with CA 19-9 increase in the same period (p = 0.01). Change in CEA and CA 72-4 values was not statistically significant.
CA 19-9 levels before treatment start and after end of preoperative CT correlate with progression free survival of patients with esophagogastric cancers. CA 19-9 decline after CT is prognostic for PFS as well. This observation can be used for CA 19-9 testing in order to distinguish chemosensitive and chemoresistant disease. This abstract was supported by a grant from the Ministry of Health of the Czech Republic – IGA MZ CR NT12331-5/2011 and by a grant from the Charles University Prague PRVOUK-P-27/LF/1.