Preoperative tumor markers, pathological aggressiveness, and local recurrence in gastric cancer after gastrectomy

Abstract

Aims: This study evaluated the association of preoperative carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels at diagnosis with pathological aggressiveness and local recurrence in patients with gastric cancer undergoing gastrectomy. Methods: This retrospective single-center study included 58 patients who underwent subtotal or total gastrectomy and had available preoperative tumor markers. CEA >5 ng/ml and CA19-9 >37 U/ml were considered elevated. Clinicopathological data, recurrence patterns, disease-free survival (DFS) events, and overall survival were analyzed. Results: Elevated CEA and CA19-9 were detected in 17 (29.31%) and 12 (20.69%) patients, respectively. At least one marker was elevated in 24 patients (41.38%), and both markers were elevated in 5 (8.62%). During follow-up, local recurrence occurred in 7 patients (12.07%), peritoneal recurrence in 16 (27.59%), distant metastasis in 9 (15.52%), and DFS events in 21 (36.21%). Local recurrence was not significantly associated with tumor marker status. However, patients with DFS events had higher CEA and CA19-9 levels (p=0.029 and p=0.006). Elevation of either marker was associated with DFS events (p=0.026), while concomitant elevation was associated with N3 disease and advanced pathological stage. Conclusion: In this limited cohort, preoperative CEA and CA19-9 levels were not significantly associated with local recurrence, but they may reflect tumor burden, nodal involvement, and risk of DFS events after gastrectomy.