Objective   The influences of detection of the preoperative level of serum CA19-9 were analyzed on the prognosis of gastric cancer patients.

  Methods   A total of 513 gastric patients with preoperative CA19-9 detection were enrolled and underwent radical gastrectomy in Tianjin Medical University Cancer Institute and Hospital from January 2003 to October 2008. Clinico-pathological variables associated with the CA19-9 level were analyzed, and the prognostic value of CA19-9 was evaluated.

  Results   Eighty-six (16.8%) patients manifested an increased CA19-9 level, which was associated with ageing, Borrmann types Ⅲand Ⅳ, undifferentiated type, and advanced T stage. The five-year survival rates were 45.7% and 25.6% for patients with normal (< 39 U/mL) and significantly high CA 19-9 levels (≥39 U/mL), respectively. Differences in survival rates between the patient groups were statistically significant (P < 0.001). Tumor-node-metastasis (TNM)-stratified analysis revealed a difference in overall survival for patients with stage Ⅲ tumors. The significantly increased CA19-9 level was an independent prognostic factor for gastric cancer patients after radical surgery based on multivariate analysis.

  Conclusions   Detection of preoperative level of serum CA19-9 could provide important information for prognostic evaluation of gastric cancer patients. CA19-9 was a potential independent prognostic factor for gastric cancer patients after surgery.