Adjuvant chemotherapy, p53, carcinoembryonic antigen expression and prognosis after D2 gastrectomy for gastric adenocarcinoma

doi:10.3748/wjg.v20.i1.264

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

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World J Gastroenterol. Jan 7, 2014; 20(1): 264-273
Published online Jan 7, 2014. doi: 10.3748/wjg.v20.i1.264

Table 1 Clinicopathological characteristics of patients with stage II/III gastric cancer n (%)

Characteristic	Surgery alone	Surgery + chemotherapy	P value
No. of patients	117	169
Age (yr)
Median (range)	62 (31-80)	58 (25-80)	0.063
< 70	89 (76.1)	142 (84.0)	0.093
≥ 70	28 (23.9)	27 (16.0)
Sex, n			0.924
Men	83 (70.9)	119 (70.4)
Women	34 (29.1)	50 (20.6)
Karnofsky performance status			0.515
≥ 90	116 (99.1)	166 ( 98.2)
≥ 80	1(0.9)	3 (1.8)
Tumor location			0.054
Proximal	77 (65.8)	92 (54.4)
Distal	40 (34.2)	77 (45.6)
Histological grade			0.120
High differentiation	0 (0.0)	4 (2.4)
Moderate differentiation	32 (27.4)	35 (20.7)
Low differentiation	85 (72.6)	130 (76.9)
Gloss type			0.429
Protrusion	41 (35.0)	64 (37.9)
Ulcer	71 (60.7)	102 (60.4)
Infiltration	5 (4.3)	3 (1.8)
Tumor size			0.359
< 5 cm	41 (35.3)	51 (30.2)
≥ 5 cm	75 (64.7)	118 (60.8)
Preoperative serum CEA			0.207
Median (range)	2.42 (0.2–326.8)	2.235 (0.2–265.5)
Preoperative serum CA19-9			0.729
Median (range)	11.33 (0.6–206.9)	10.83 (0.6–3098.0)
CEA tumor status			0.792
–	12 (10.3)	19 (11.2)
+	105 (89.7)	150 (88.8)
P53 tumor status			0.813
–	27 (23.1)	37 (21.9)
+	90 (76.9)	132 (78.1)
T category			0.182
T1	0 (0.0)	2 (1.2)
T2	7 (6.0)	20 (11.8)
T3	91 (77.8)	116 (68.6)
T4	19 (12.6)	31 (18.3)
N category			0.069
N0	31 (26.5)	37 (21.9)
N1	19 (16.2)	29 (17.2)
N2	33 (28.2)	31 (18.3)
N3	34 (29.1)	72 (42.6)
AJCC stage (7^th)			0.066
IIA	29 (24.8)	38 (22.5)
IIB	11 (9.4)	26 (15.4)
IIIA	34 (29.1)	34 (20.1)
IIIB	40 (34.2)	56 (33.1)
IIIC	3 (2.6)	15 (8.9)

CEA: Carcinoembryonic antigen.

Table 2 p53 tumor status, carcinoembryonic antigen tumor status and clinicopathological parameters n (%)

Characteristic	p53(+) (n = 222)	CEA(+) (n = 255)
Age (yr)	P = 0.406	P = 0.056
< 70	177 (76.6)	202 (87.4)
≥ 70	45 (81.8)	53 (96.4)
Sex, n	P = 0.804	P = 0.227
Men	156 (77.2)	183 (90.6)
Women	66 (78.6)	72 (85.7)
Tumor location	P = 0.271	P = 0.040
Proximal	135 (79.9)	156 (92.3)
Distal	87 (74.4)	99 (84.6)
Histological grade	P = 0.248	P = 0.248
High differentiation	4 (100)	4 (100)
Moderate differentiation	48 (71.6)	63 (94.0)
Low differentiation	170 (79.1)	188 (87.4)
Gloss type	P = 0.041	P = 0.954
Protrusion	73 (69.5)	93 (88.6)
Ulcer	142 (82.1)	155 (89.6)
Infiltration	7 (87.5)	7 (87.5)
Tumor size	P = 0.684	P = 0.103
< 5 cm	70 (76.1)	86 (93.5)
≥ 5 cm	151 (78.2)	168 (87.0)
T category	P = 0.420	P = 0.883
T1	2 (100)	2 (100)
T2	19 (70.4)	25 (92.6)
T3	165 (79.7)	184 (88.9)
T4	36 (72.0)	44 (88.0)
N category	P = 0.923	P = 0.198
N0	54 (79.4)	57 (83.8)
N1	38 (79.2)	45 (93.8)
N2	50 (78.1)	60 (93.8)
N3	80 (75.5)	90 (87.7)
AJCC stage (7^th)	P = 0.211	P = 0.741
IIA	51 (76.1)	58 (86.6)
IIB	30 (81.1)	33 (89.2)
IIIA	58 (85.3)	63 (92.6)
IIIB	72 (75.0)	86 (89.6)
IIIC	11 (61.1)	15 (83.3)

CEA: Carcinoembryonic antigen.

Table 3 Univariate and multivariate analyses of survival

Clinicopathological factor		DFS			OS
		Univariate	Multivariate	Multivariate P value	Univariate	Multivariate	Multivariate P value
		HR (95%CI)	HR (95%CI)	Multivariate P value	HR (95%CI)	HR (95%CI)	Multivariate P value
Sex	Women	Reference			Reference
	Men	0.89 (0.63-1.26)			1.00 (0.67-1.51)
Age (yr)	≥ 70	Reference			Reference
	< 70	0.87 (0.59-1.30)			0.65 (0.42-1.0)
Performance status	≥ 90	Reference			Reference
	≥ 80	2.64 (0.84-8.34)			1.84 (0.45-7.47)
Tumor location	Distal	Reference			Reference		0.099
	Proximal	1.22 (0.88-1.70)			1.51 (1.02-2.24)	1.40 (0.94-2.09)
Differentiation	Low	Reference			Reference
	Moderate	0.81 (0.56-1.19)			0.78 (0.50-1.21)
	High	0.20 (0.03-1.47)			0.31 (0.04-2.27)
Gloss type	Protrusion	Reference		0.081	Reference		0.008
	Ulcer	0.81 (0.58-1.14)	0.83 (0.59-1.18)	0.301	0.70 (0.47-1.03)	0.69 (0.46-1.03)	0.072
	infiltration	2.31 (1.05-5.07)	1.94 (0.86-4.37)	0.108	2.56 (1.15-5.69)	2.19 (0.95-5.05)	0.066
Tumor size	< 5 cm	Reference		0.363	Reference		0.099
	≥ 5 cm	1.45 (1.04-2.01)	1.17 (0.84-1.63)		1.67 (1.15-2.43)	1.40 (0.94-2.09)
Preoperative serum CEA	≥ median	Reference			Reference
	< median	0.94 (0.68-1.31)			0.84 (0.58-1.23)
Preoperative serum CA19-9	≥ median	Reference			Reference
	< median	0.84 (0.575-1.24)			0.85 (0.54-1.34)
CEA tumor status	+	Reference			Reference
	-	1.00 (0.59-1.68)			0.45 (0.20-1.03)
P53 tumor status	+	Reference			Reference
	-	1.40 (0.98-2.01)			1.12 (0.72-1.75)
AJCC stage (7^th)	III	Reference		0	Reference		0.000
	II	0.36 (0.24-0.53)	0.63 (0.51-0.77)		0.32 (0.20-0.51)	0.59 (0.46-0.75)
Radical surgery	R1	Reference		0.006	Reference		0.214
	R0	0.34 (0.19-0.60)	0.43 (0.23-0.78)		0.45 (0.23-0.86)	0.65 (0.33-1.28)
Adjuvant chemotherapy	Yes	Reference		0.008	Reference		0.000
	No	1.58 (1.15-2.17)	1.55 (1.12-2.14)		1.99 (1.38-2.87)	2.01 (1.37-2.94)
First-line chemotherapy	Yes				Reference		0.013
	No				1.87 (1.14-3.07)	1.95 (1.15-3.30)

CEA: Carcinoembryonic antigen; OS: Overall survival; DFS: Disease-free survival.

Citation: He MM, Zhang DS, Wang F, Wang ZQ, Luo HY, Ren C, Jin Y, Chen DL, Xu RH. Adjuvant chemotherapy, p53, carcinoembryonic antigen expression and prognosis after D2 gastrectomy for gastric adenocarcinoma. World J Gastroenterol 2014; 20(1): 264-273
URL: https://www.wjgnet.com/1007-9327/full/v20/i1/264.htm
DOI: https://dx.doi.org/10.3748/wjg.v20.i1.264