Pretreatment Serum Carbohydrate Antigen 19-9 Concentration Is a Predictor of Survival of Patients Who Have Undergone Curative Resection of Stage IV Rectal Cancer

Abstract

Background: To evaluate whether pretreatment carcinoembryonic antigen and carbohydrate antigen (CA)19-9 are useful predictors of survival in patients with stage IV rectal cancer who have undergone curative resection. Methods: In this retrospective study, data on 73 patients who had undergone curative resection of stage IV rectal cancer were reviewed. Associations between various clinicopathological factors and survival outcomes were analyzed. Results: According to univariate analysis, elevated pretreatment CA19-9 (p = 0.0028), R1 resection (p = 0.0318), and mucinous or poorly differentiated adenocarcinoma (p = 0.0228) were significantly associated with poor overall survival (OS), and lymph node metastasis (p = 0.0211) was significantly associated with poor disease-free survival (DFS). Multivariate analyses showed that elevated pretreatment serum CA19-9 concentration (hazard ratios [HR] 3.33; 95% CI 1.24-9.42; p = 0.0174) was an independent predictor for OS and lymph node metastasis (HR 2.26; 95% CI 1.15-4.82; p = 0.0164) was an independent predictor for DFS. Among 55 patients with recurrences after curative resection, the rate of complete resection of recurrences was significantly higher in patients with normal pretreatment CA19-9 than in those with elevated CA19-9 (p = 0.049). Post-recurrence survival was significantly worse in patients with elevated pretreatment CA19-9 than in those with normal CA19-9 (p = 0.0196). Conclusions: Pretreatment CA19-9 is good predictor of survival after curative resection of stage IV rectal cancer.

Prognostic significance of carcinoembryonic antigen combined with carbohydrate antigen 19‐9 following neoadjuvant chemoradiotherapy in patients with locally advanced rectal cancer

“…The tumour markers CEA and CA19‐9 are common indicators for preoperative early diagnosis, treatment monitoring and postoperative follow‐up, but their prognostic performance in patients with LARC undergoing nCRT remains under investigation. At present, elevated serum CEA has been classified into category I according to the strength and reliability of the published evidence in the literature, and the prognostic significance of CA19‐9 has also been confirmed by an increasing number of studies [11,12,18], including our previous research [11]. However, most previous studies only analysed single tumour markers and mainly focused on the pretreatment level [9,10].…”

Preoperative volumetric synthetic magnetic resonance imaging of the primary tumor for a more accurate prediction of lymph node metastasis in rectal cancer

“…Whether CEA, CA199 levels, and MTL could serve as a predictor of LN metastasis remains controversial, possibly due to the heterogeneous populations of rectal cancer patients across different studies. Several studies have reported no associations between CEA, CA199 levels, MTL, and LN status (28-30), while others found that they were preoperative predictors of LN metastasis (31,32).…”

Predictive value of carcinoembryonic antigen and carbohydrate antigen 19-9 related to downstaging to stage 0–I after neoadjuvant chemoradiotherapy in locally advanced rectal cancer

“…Meanwhile, CA 19-9 is another widely used tumor marker in gastrointestinal tumor and is a significant predictor of survival for rectal cancer 30–32. However, few studies analyzed the association between CA19-9 and nCRT response.…”

“…Meanwhile, CA 19-9 is another widely used tumor marker in gastrointestinal tumor and is a significant predictor of survival for rectal cancer. 30 – 32 However, few studies analyzed the association between CA19-9 and nCRT response. Our study suggested that pretreatment CA19-9 and pre–post-CA19-9 ratio were significantly associated with stage ypT0-2N0 tumor, and pre–post-CA19-9 ratio was significantly associated with pCR.…”