Prognostic value of preoperative serum CEA level compared to clinical staging. IV. Histological grading and tumor type in colorectal and gastric cancer.

In a clinical investigation of observed postoperative survival, 410 patients with colorectal cancer and 269 patients with stomach cancer have been registered for primary surgical treatment connected with a long-term follow up. Histologic grading and tumor typing were examined as potential prognostic factors and compared with the prognostic information covered by operability, tumor extension, and the preoperative CEA level. Statistical treatment of the data revealed no prognostic significance of the tumor types adenocarcinoma, mucinous, and anaplastic tumours in gastric cancer. Histologic grading specified ranges associated with significant differences in survival of gastric and colorectal cancer patients. However, histologic grading did not provide prognostic information in addition to operability and tumor extension. However, histologic grading gave additional prognostic information to preoperative CEA levels in the range of 0-5 micrograms CEA/1 serum but not in the range greater than 5 micrograms CEA/1. The results indicate that the prognostic information of preoperative serum CEA level is not directly linked to the histologic grade of a tumor.