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Research ArticleClinical Studies

The Clinical Significance of CA19-9 and Tumor Size Ratios for Predicting Prognosis After Conversion Surgery in Patients With Stage IV Gastric Cancer

KEISHI OKUBO, TAKAAKI ARIGAMI, DAISUKE MATSUSHITA, YOSHIKAZU UENOSONO, SHIGEHIRO YANAGITA, TAKASHI KIJIMA, YUSUKE TSURUDA, MASAHIRO NODA, KEN SASAKI, SHINICHIRO MORI, HIROSHI KURAHARA and TAKAO OHTSUKA
Anticancer Research November 2021, 41 (11) 5643-5649; DOI: https://doi.org/10.21873/anticanres.15380
KEISHI OKUBO
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
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  • For correspondence: k5658877@kadai.jp
TAKAAKI ARIGAMI
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
2Department of Onco-biological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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DAISUKE MATSUSHITA
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
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YOSHIKAZU UENOSONO
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
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SHIGEHIRO YANAGITA
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
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TAKASHI KIJIMA
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
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YUSUKE TSURUDA
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
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MASAHIRO NODA
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
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KEN SASAKI
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
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SHINICHIRO MORI
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
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HIROSHI KURAHARA
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
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TAKAO OHTSUKA
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan;
2Department of Onco-biological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
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Abstract

Background/Aim: The clinical benefit of conversion surgery (CS) after chemotherapy remains unclear for stage IV gastric cancer (GC) patients. This study aimed to investigate the prognostic factors used to determine whether CS is a promising therapeutic strategy. Patients and Methods: We retrospectively analyzed data from 156 patients diagnosed with unresectable stage IV GC who underwent chemotherapy as the initial treatment, including 40 patients who had R0 resection in CS. Results: The median survival time of the CS patients was significant longer than that of patients who underwent chemotherapy alone. A multivariate analysis identified only pN3 as an independent prognostic factor in CS patients. Among the differentiated tumor type patients, carbohydrate antigen 19-9 (CA19-9) levels were significantly higher in pN3 patients than in pN0-2 patients before chemotherapy. Among undifferentiated tumor type patients, pN3 patients had a significantly lower tumor size ratio (before chemotherapy/before surgery) than pN0-2 patients. Conclusion: Although it is clinically difficult to diagnose lymph node metastasis using preoperative examinations, CA19-9 levels and tumor size ratios may be preoperative indicators for predicting pN3, which is associated with a poor prognosis in CS.

Key Words:
  • Gastric cancer
  • conversion surgery
  • CA19-9
  • tumor size ratio
  • Received June 22, 2021.
  • Revision received October 13, 2021.
  • Accepted October 14, 2021.
  • Copyright © 2021 International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.
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Anticancer Research: 41 (11)
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The Clinical Significance of CA19-9 and Tumor Size Ratios for Predicting Prognosis After Conversion Surgery in Patients With Stage IV Gastric Cancer
KEISHI OKUBO, TAKAAKI ARIGAMI, DAISUKE MATSUSHITA, YOSHIKAZU UENOSONO, SHIGEHIRO YANAGITA, TAKASHI KIJIMA, YUSUKE TSURUDA, MASAHIRO NODA, KEN SASAKI, SHINICHIRO MORI, HIROSHI KURAHARA, TAKAO OHTSUKA
Anticancer Research Nov 2021, 41 (11) 5643-5649; DOI: 10.21873/anticanres.15380

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The Clinical Significance of CA19-9 and Tumor Size Ratios for Predicting Prognosis After Conversion Surgery in Patients With Stage IV Gastric Cancer
KEISHI OKUBO, TAKAAKI ARIGAMI, DAISUKE MATSUSHITA, YOSHIKAZU UENOSONO, SHIGEHIRO YANAGITA, TAKASHI KIJIMA, YUSUKE TSURUDA, MASAHIRO NODA, KEN SASAKI, SHINICHIRO MORI, HIROSHI KURAHARA, TAKAO OHTSUKA
Anticancer Research Nov 2021, 41 (11) 5643-5649; DOI: 10.21873/anticanres.15380
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Keywords

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