Background: Evaluating chemotherapeutic effect in patients with gastric carcinoma sometimes is difficult. The authors investigated whether changes in the serum levels of three tumor markers can be used to predict the clinical outcome after chemotherapy.
Methods: Thirty patients with advanced and recurrent gastric carcinoma were treated with continuous 5-fluorouracil and low dose cisplatin for 4 weeks. Thirteen patients were treated neoadjuvantly prior to gastrectomy. The serum levels of carcinoembryonic antigen, carbohydrate antigen 19-9, and sialyl-Tn antigen were measured prior to and after chemotherapy. Responders were defined as those in whom abnormal serum levels of all three markers decreased to at least 50% of the pretreatment values and remained stable for at least 1 month.
Results: The tumor markers could be evaluated in 27 of 30 patients (90%). The median duration of survival for the 15 responders and 12 nonresponders was 17 months and 6 months, respectively. There was a significant difference in the median duration of survival between the responders and nonresponders using the log rank test (P=0.0005). In the patients who received neoadjuvant therapy, the eight responders had a significantly longer survival period than did the three nonresponders (P=0.018). Seven of the eight responders showed evidence of tumor destruction histologically whereas none of the three nonresponders did.
Conclusions: Changes in the serum levels of these tumor markers after chemotherapy may be an excellent prognostic indicator for patients with gastric carcinoma.