title: Preoperative serum level of CA19-9 predicts recurrence after curative surgery in node-negative colorectal cancer patients.
abstract: 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.
authors.affiliation: First Department of Surgery, Nagasaki University School of Medicine, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. nakagoe@net.nagasaki-u.ac.jp
authors.forename: Tohru
authors.initials: T
authors.lastname: Nakagoe
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Takashi
authors.initials: T
authors.lastname: Tsuji
authors.forename: Masa-aki
authors.initials: MA
authors.lastname: Jibiki
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Yamaguchi
authors.forename: Toru
authors.initials: T
authors.lastname: Yasutake
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Ayabe
authors.forename: Kokichi
authors.initials: K
authors.lastname: Arisawa
mesh_terms: 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
chemical_list: D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen