Preoperative serum level of CA19-9 predicts recurrence after curative surgery in node-negative colorectal cancer patients.
OBJECTIVE
We hypothesize that a subset of node-negative colorectal cancer patients exists that is at high risk for recurrence after curative surgery. Preoperative serum levels of sialyl Lewisa (CA19-9), sialyl Lewisx (SLX), sialyl Tn (STN), and carcinoembryonic (CEA) antigens were analyzed for their value in predicting for such a group.


METHODS
One-hundred-forty-five patients with node-negative, T1-4, M0 colorectal cancers were divided into groups of low or high serum antigen levels. Disease-free interval served as the endpoint in evaluating the prognostic strength of each variable.


RESULTS
Twenty-seven patients (18.6%) were included in the high group for CA19-9 antigen, 11 (7.6%) for SLX, 13 (9.0%) for STN, and 51 (35.2%) for CEA. The median follow-up was 62.1 months. As compared to those with low levels, patients with elevated CA19-9 had a shorter disease-free interval (P = 0.0026). No significant difference in disease-free interval was noted between low and high groups of SLX, STN, and CEA antigens. Cox regression analysis identified elevated serum CA19-9 level as a predictor for decreased disease-free interval, independent of T-stage or tumor location.


CONCLUSIONS
Elevated preoperative serum levels of CA19-9 may serve as a useful marker in identifying patients with node-negative colorectal cancers at high risk for recurrence after surgery.
Nakagoe
Tohru
T
First Department of Surgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. nakagoe@net.nagasaki-u.ac.jp
Sawai
Terumitsu
T
Tsuji
Takashi
T
Jibiki
Masa-aki
MA
Nanashima
Atsushi
A
Yamaguchi
Hiroyuki
H
Yasutake
Toru
T
Ayabe
Hiroyoshi
H
Arisawa
Kokichi
K
D000230:Adenocarcinoma / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood / Q000175:diagnosis / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000175:diagnosis*; D009367:Neoplasm Staging; D011237:Predictive Value of Tests
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen