Normal carcinoembryonic antigen indicates benefit from perioperative chemotherapy to gastric carcinoma patients

摘要

AIM:To evaluate pretreatment serum carcinoembryonic antigen(CEA) as a predictor of survival for patients with locally advanced gastric cancer receiving perioperative chemotherapy.METHODS:We retrospectively studied a cohort of 228 gastric cancer patients who underwent D2 gastrectomy combined with chemotherapy at the Sun Yat-sen University Cancer Center between January 2005 and December 2009.Among them,168 patients received 6-12 cycles of oxaliplatin-based adjuvant(post-operative) chemotherapy,while 60 received perioperative chemotherapy(2 cycles of FOLFOX6 or XELOX before surgery and 4-10 cycles after surgery).Serum CEA was measured using an enzyme immunoassay.The followup lasted until December 2010.RESULTS:In the group that had elevated serum CEA,the difference in survival time between patients receiving perioperative chemotherapy and those receiving adjuvant chemotherapy had no statistical significance(P > 0.05).However,in the group that had normal serum CEA,patients receiving perioperative chemotherapy had a longer survival time.In multivariate analysis,T staging and lymph node metastatic rate were independent prognostic factors for the patients.Perioperative chemotherapy improved the overall survival of patients who had a normal pretreatment CEA level(P = 0.070).CONCLUSION:Normal pretreatment serum CEA is a predictor of survival for patients receiving perioperative chemotherapy.