Prognostic value of preoperative serum CEA level compared to clinical staging: Ii. Stomach cancer

Abstract

Summary.-In a clinical investigation of postoperative survival after primary surgery for stomach cancer, 390 patients were registered since 1974. The potential prognostic parameters examined within the first days of hospitalization for primary resection included age of the patients, operability, tumour extension (TNM classification) and tumour stages I-IV (UICC). Statistical treatment of the data revealed that each of the clinical parameters covers critical ranges associated with highly significant differences in patient survival. The preoperative serum CEA concentration exhibited prognostic significance in addition to the criteria of operability and tumour extension. In selected subgroups of patients with distinct resectability and tumour extension, ranges of preoperative CEA concentration could be specified which were associated with statistically significant differences in the patient survival. The results indicate that the preoperative serum CEA level can be an independent prognostic parameter in stomach cancer.

Multivariate analyses as aids to diagnosis and assessment of prognosis in gastrointestinal cancer

“…This demonstrated that stage is clearly a prognostic factor, and that an improvement in the accuracy of the prediction could be achieved by adding the anatomical site of the primary tumour 0 --I'll90 or (Table II), but once these factors were taken into account the histology and biochemical variates did not add further information. Following the report of (Staab et al, 1982) the assessment of prognosis was also performed excluding those patients who died within 4 weeks of their operation; both stage and site remained the most important prognostic factors. Figure 2 shows the way in which the model predicts survival differences of male patients aged 67 years with tumours of various stages, and how the survival probability is worse in patients who have a high ACT level, compared to those in which these levels are within normal limits.…”

“…There is now a large body of evidence that preoperative high blood levels of carcinoembryonic antigen (CEA) in colorectal cancer and in gastric cancer will be associated with a decreased survival, especially of patients with locally advanced or metastatic tumours (Staab et al, 1981(Staab et al, , 1982Wanebo et al, 1978). However, the prognostic significance of slightly raised levels of CEA is still debatable (Goslin et al, 1980;Blake et al, 1982;Steel et al, 1982).…”

Tumour markers

“…[29] Dijagnostička osetljivost CEA za kolorektalni karcinom iznosi 70%, a specifičnost 95%. Posle adekvatne terapije nivo u serumu se vraća u granicama normale, dok ponovni porast koncentracije ukazuje na progresiju bolesti ili prisustvo metastaza [30].…”

“…Povišene koncentracije CEA nalaze se u serumu pacijenata sa karcinomima drugih organa: jetre, pluća, dojke, pankresa, želuca, bubrega, jajnika, prostate kao i u nekim benignim stanjima: ciroza, upalne bolesti creva, hronične plućne bolesti, pankreatitis, benigna hipertrofija prostate [30].…”

CEA preoperatorio como factor pronóstico en cáncer de colon y recto: análisis de 532 pacientes

“…GUILLERMO BANNURA C. 1 , MIGUEL A. CUMSILLE G. 2 , ALEJANDRO BARRERA E. 1 , JAIME CONTRERAS P. 1 , DANIEL SOTO C. 1 , CARLOS MELO L. 1 , CLAUDIO ZÚÑIGA T. 1 1 Servicio y Departamento de Cirugía Hospital Clínico San Borja Arriarán. 2 Escuela de Salud Pública. Facultad de Medicina Universidad de Chile, Santiago, Chile.…”