Abstract
Background: The present study was undertaken to investigate whether serum levels of carbohydrate antigen (CA) 19-9 is effective for predicting prognosis in patients with advanced urothelial carcinoma (UC). Methods: Patients diagnosed as locally advanced or metastatic or recurrent UC in our department between Apr 2008 to Oct 2014 were evaluated retrospectively. Pathological TNM stage was showed if patients underwent radical surgery, and clinical TNM stage was showed if not. Metastatic disease was defined as positive for extra-regional lymph node metastasis or metastasis in other organs. CA 19-9 was assayed with ELISA reader for all cases and expressed in U/ml with 30 U/ml taken as the cut-off upper value for normal. One-way analysis of variance and Student's or Welch's t-test were used for comparative data analysis. Kaplan-Meier method and log-rank test were used to compare survival time. Results: Out of 40 cases enrolled, 7 patients who showed a low value in serum CA 19-9 (<= 2 U/ml) were eliminated because they were highly suspected of Lewis A negative blood type. Two patients in advanced state with multiple liver metastases were also eliminated. Median follow-up time was 12 months. The mean values of CA 19-9 was 36.6 U/ml. The values in serum CA 19-9 were not significantly different among three types of UC. The percentage of rise in CA 19-9 for >= T3 tumors was significantly high when compared to <= T2 tumors (p = 0.034). Conversely, the percentage of rise in CA 19-9 for metastatic disease was not significantly high when compared to non-metastatic disease (p = 0.276). T stage and metastatic state did not correlate with prognosis except DSS in metastatic disease (p = 0.014), however, patiens with high serum CA 19-9 levels demonstrated significantly better prognosis in DSS and OS than that of low levels (p = 0.022, p = 0.019, respectively). Conclusion: Patients of advanced urothelial carcinoma with high serum CA 19-9 levels may predict good prognosis.
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