Prognostic value of CEA mRNA in the peritoneal lavage of patients undergoing curative surgery for gastric cancer.

Abstract Aim To evaluate the prognostic value of tumor markers in a European cohort of patients with resectable gastric cancer. Methods We performed a post hoc analysis of the CRITICS trial, in which 788 patients received perioperative therapy. Association between survival and pretreatment CEA, CA 19-9, alkaline phosphatase, neutrophils, hemoglobin and lactate dehydrogenase were explored in uni- and multivariable Cox regression analyses. Likelihoods to receive potentially curative surgery were investigated for patients without elevated tumor markers versus one of the tumor markers elevated versus both tumor markers elevated. The association between tumor markers and the presence of circulating tumor DNA (ctDNA) was explored in 50 patients with available ctDNA data. Results In multivariable analysis, in which we corrected for allocated treatment and other baseline characteristics, elevated pretreatment CEA (HR 1.43; 95% CI 1.11–1.85, p < 0.001) and CA 19-9 (HR 1.79; 95% CI 1.42–2.25, p < 0.001) were associated with worse OS. Likelihoods to receive potentially curative surgery were 86%, 77% and 60% for patients without elevated tumor marker versus either elevated CEA or CA 19-9 versus both elevated, respectively (p < 0.001). Although both preoperative presence of ctDNA and tumor markers were prognostic for survival, no association was found between these two parameters. Conclusion CEA and CA 19-9 were independent prognostic factors for survival in a large cohort of European patients with resectable gastric cancer. No relationship was found between tumor markers and ctDNA. These factors could potentially guide treatment choices and should be included in future trials to determine their definitive position. Trial registration ClinicalTrial.gov identifier: NCT00407186. EudraCT number: 2006-00413032.

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Peritoneal Lavage CEA mRNA Levels Predict Conversion Gastrectomy Outcomes after Induction Chemotherapy with Intraperitoneal Paclitaxel in Gastric Cancer Patients with Peritoneal Metastasis

Annals of Surgical Oncology ◽

10.1245/s10434-017-5997-x ◽

2017 ◽

Vol 24 (11) ◽

pp. 3345-3352 ◽

Cited By ~ 1

Author(s):

Hironori Yamaguchi ◽

Yumiko Satoh ◽

Hironori Ishigami ◽

Makiko Kurihara ◽

Yutaka Yatomi ◽

...

Keyword(s):

Gastric Cancer ◽

Cancer Patients ◽

Induction Chemotherapy ◽

Peritoneal Metastasis ◽

Peritoneal Lavage ◽

Mrna Levels ◽

Gastric Cancer Patients ◽

Cea Mrna

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The evaluation of peritoneal lavage tumor markers for gastric cancer

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e15643 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e15643-e15643

Author(s):

M. Yamamoto ◽

T. Ishida

Keyword(s):

Gastric Cancer ◽

Tumor Markers ◽

Peritoneal Lavage ◽

Peritoneal Dissemination ◽

Stage Iv ◽

Ca 125 ◽

Peritoneal Carcinoma ◽

Curative Surgery ◽

Stage Ia ◽

Gastric Cancer Patients

e15643 Background: We have found that elevation of preoperative peritoneal lavage CEA levels is associated with an earlier detection of recurrent peritoneal dissemination and a poor prognosis. Methods: We have now examined findings with the combined of peritoneal lavage CEA, CA125 and CA72–4 levels with regard to prediction of the prognosis of gastric cancer patients. Ninety-four patients who were underwent surgery with gastric cancer were intraoperatively measured for tumor markers, CEA, CA125 and CA72–4 in peritoneal lavage using a chemiluminescent enzyme immunoassay. We examined whether the stage with patients were related with tumor markers in peritoneal lavage. Results: The averages of peritoneal lavage CEA, CA 125 and CA72–4 levels in patients with peritoneal carcinoma were 24.3, 299, 6.70, respectively, while those in patients without peritoneal carcinoma were 0.77, 258, 0.95, respectively. The averages of peritoneal lavage CEA and CA72–4 levels in patients with peritoneal carcinoma were significantly increased with those in patients without peritoneal carcinoma (p<0.0001). In patients who were performed a curative surgery, the averages of peritoneal lavage CEA level were 0.55, 0.51, 0.51, 1.98, 0.50, 11.0 in cases of stage IA, IB, II, IIIA, IIIB and IV. Similarly, the averages of peritoneal lavage CA125 level were 254, 260, 307, 148, 366 and 280, and the average of peritoneal lavage CA72–4 level were 0.88, 1.06, 0.98, 0.90 and 3.23. The peritoneal lavage CEA or CA72–4 level in cases of stage IV was increased than in cases of other stages. The RFS of patients in the CEA level above cut-off was shorter than that in the CEA level below cut-off. However, the RFS of patients in the CA72–4 level above cut-off was not differ with that in the CA72–4 level below cut-off. In a multivariate analysis, the peritoneal lavage both CEA and CA72–4 levels above cut-off were found to be significant and independently prognostic factor (p= 0.0427). Conclusions: This combined assay of peritoneal lavage both CEA and CA72–4 levels will aid in estimating the prognosis. No significant financial relationships to disclose.

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Lymph Node Ratio Predicts Overall Survival in pT4 Gastric Cancer Patients who Underwent Curative Surgery

10.21203/rs.3.rs-497740/v1 ◽

2021 ◽

Author(s):

Fan Yang ◽

Xinying Yu ◽

Qi Li ◽

Jun Wu ◽

Yang Chen ◽

...

Keyword(s):

Gastric Cancer ◽

Overall Survival ◽

Lymph Node ◽

Prognostic Factor ◽

Lymph Nodes ◽

Prognostic Value ◽

Lymph Node Ratio ◽

Curative Surgery ◽

Cutoff Values ◽

Node Ratio

Abstract Background: Lymph node ratio (LNR), the ratio of metastatic lymph nodes to the total number of examined lymph nodes, has been considered a prognostic factor in gastric cancer (GC) patients. However, the predictive values of LNR vary as characteristics of patients are different. We confirmed its prognostic value and investigated the differences between patients with different pathological features.Methods: Totally, 211 GC patients who underwent curative gastrectomy between October 2004 and November 2016 were retrospectively investigated. Patients were classified into LNR 0, 1 and 2, using cutoff values 0.05 and 0.2. Cutoff values were calculated by Youden index. Relationships between LNR and clinicopathological characteristics were investigated by chi-square test or Fisher's exact test. Survival analysis were based on Cox proportional hazard regression model and Kaplan-Meier method.Results: LNR were related to tumor size (p = 0.003), Lauren classification (p = 0.007), grade of differentiation (p = 0.041), pT stage (p = 0.050) and pN stage (p < 0.001). In multivariable analysis, LNR was an independent prognostic factor (HR = 7.023, p < 0.001). In stratification analysis, LNR showed independent prognostic value (HR = 4.852, p < 0.001) in pT4 patients, but not in pT3 patients (p = 0.361) and pT1-2 patients (p = 0.123). Conclusions: LNR is an independent predictor of overall survival in pT4 GC patients who underwent curative surgery.

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