P-059 - Can high levels of preoperative carbohydrate antigen 19-9 be a predictor of survival in gastric cancer?

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Gastric Cancer
Translational Research
Surgical Oncology
Basic Principles in the Management and Treatment (of cancer)
Radiation Oncology
Presenter A. Garcia
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors A. Garcia1, N. Saraiva1, A. Nogueira1, P. Jacinto2, M. Marques3, N. Bonito1, J. Ribeiro1, H. Gervasio1
  • 1Portuguese Oncology Institute of Coimbra, Coimbra/PT
  • 2Instituto Português de Oncologia Francisco Gentil, Coimbra/PT
  • 3Portuguese Institute of Oncology Coimbra, Coimbra/PT



Carcinoembryonic antigen (CEA) and carbohydrate antigen (CA) 19-9 are commonly used tumour markers for monitoring treatment and recurrence of gastric cancer. However, their value as a preoperative prognostic tool is not well established.


Between 2006 and 2012, a total of 202 patients underwent surgery for histologically confirmed gastric cancer (32 patients were excluded due to incomplete information): 24 patients had elevated serum levels of CA 19-9 preoperatively and 146 patients had normal levels (upper limit: 37U/mL). For this study, 48 patients were randomly selected from the latter group to serve as controls (matched for age, sex and tumour staging). Overall survival (OS) was calculated using the log-rank test. Standard statistical test were used.


We compared outcomes and clinical characteristics of 24 patients with elevated preoperative serum CA 19-9 levels (15 males/9 females; mean age: 66,2 years-old) and 48 patients with non-elevated preoperative serum CA 19-9 levels (36 males/12 females; mean age: 66,21 years-old) (p = 0,162). Location, histological subtype, tumour grade, metastasized nodes and stage of both groups were similar. Palliative surgery was performed in 13 cases (elevated CA 19-9 in 5 patients and normal CA 19-9 in 8 patients); 14 patients had a total gastrectomy (elevated CA 19-9 levels: 5; normal CA 19-9: 9) and 45 subtotal gastrectomy (14 vs 31). Regarding the type of surgery, there was no differences between the two groups.

The median overall survival (OS) was significantly longer in patients with normal CA 19-9 than in patients with elevated levels of this tumour marker (98,3 months vs. 19,4 months, p 0,022). Median OS of the two groups combined was 52 months.


Patients with normal preoperative CA 19-9 levels have better prognosis than patients with elevated levels. As such, preoperative CA 19-9 levels should be considered an independent prognostic factor in predicting OS in patients with resected gastric cancer, therefore contributing to a better knowledge of disease behaviour.