Abstract
Aim: Demonstrate that preoperative tumor markers are prognostic factor in colon rectal cancer and their high levels are correlated with bad prognosis.Methods: We retrospectively analyzed two hundred and thirty-one patients affected by colorectal cancer who underwent radical surgery between January 2012 and August 2016 from a prospectively collected database. The study group consisted of 224 patients: 132 men and 92 women. Demographic details, surgical procedure, histopathologic diagnosis, and survival data were prospectively collected and retrospectively reviewed for this study. Normal cut off values for Carcinoembryonic antigen (CEA) and Carbohydrate Antigen 19.9 (CA 19.9) were respectively 5 ng/ml and 35 UI/ml. A P-value<0.05 was deemed to be statistically significant.Results: Tumor location was 94 times on ascending colon (42%), 13 on transverse colon (5.8%), 77 on descending colon (34.4%) and 40 on rectum (17.8%). All tumors were histologically diagnosed as adenocarcinoma of the colon-rectum and staged according to the TNM staging system. Preoperative serum CEA level was significantly associated only with T stage and serum albumin level; whereas there were no statistically significant differences between preoperative serum CA19.9 and patients’ clinical pathologic characteristics. Overall survival (OS) and disease-free survival (DFS) showed a statistically significant difference in the two groups of patients who are dichotomized according to the normal cut-off value of CEA and Ca 19.9. At the multivariate analysis both preoperative CEA and Ca 19.9 resulted as independent prognostic factor for survival with a p<0.05.Conclusion: These two tumor markers could have a role as prognostic factors leading to a stricter postsurgical follow up in those patients with elevated preoperative values.Core tip: Preoprative measurement of Cea and Ca19.9 is a cheap and routine exam. Their role could help to identify patients with poor prognosis in the preoperative period and to strictly follow up them in the post-surgical setting.
Highlights
Colorectal cancer (CRC) accounts for 13% of all cancers, it represents the third most common neoplasia and it stands for the second leading cause of cancer death in the 27 countries of the European Union [1,2]
Among the 224 investigated patients, there were 12 patients (5.3%) who were double positive for Carcinoembrionic Antigen (CEA) and CA19-9, 58 patients (25.9%) who were positive for CEA only, and 23 patients (10.3%) who were positive for CA 19-9 only
Ca19.9 Roc curves were made as well as for CEA, and they are shown in Figures 3 and 4 with a 2-Y Overall survival (OS) sensitivity and specificity respectively of 71.4 and 81.2%, and 1-Y disease-free survival (DFS) was respectively of 64.7 and 71.7%
Summary
Colorectal cancer (CRC) accounts for 13% of all cancers, it represents the third most common neoplasia and it stands for the second leading cause of cancer death in the 27 countries of the European Union [1,2]. It is necessary to identify promising prognostic factors that could preoperatively identify patients at high risk of recurrences after surgery or with a bad survival prognosis. Carcinoembrionic Antigen (CEA) and Carbohydrate 19.9 (CA 19.9) are the most common used tumor-associated antigens used in the pre- and post-operative management of patients affected by colon cancer. They can be inexpensively and measured increasing their applicability in all patients who will undergo colorectal surgery. There are several reports in the literature demonstrating their useful correlation to post-surgical [3,4,5] recurrence but there are few and controversial studies that evaluate their pre-operative prognostic values in both overall and disease-free survival. Our aim is to analyze the survival significance of preoperative serum CEA and CA 19.9 values in patients undergoing potential macroscopic curative surgical procedure for CRC
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Free) 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call
