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
Session Poster Session
Topics Oesophageal Cancer
Presenter Milada Zemanova
Citation Annals of Oncology (2014) 25 (suppl_2): ii14-ii104. 10.1093/annonc/mdu165
Authors M. Zemanova1, Z. Pechačová1, T. Haruštiak2, P. Fencl3, P. Vítek4
  • 1Oncology 1st Medical Faculty of Charles University Prague, Prague/CZ
  • 21st Medical Faulty and FN Motol, Charles University, Prague/CZ
  • 3Hospital Homolka, Prague/CZ
  • 4PTC, Prague/CZ



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.