title: Prognostic Value of Carcinoembryonic Antigen (CEA), AFP, CA19-9 and CA125 for Patients with Colorectal Cancer with Peritoneal Carcinomatosis Treated by Cytoreductive Surgery and Intraperitoneal Chemotherapy.
abstract: BACKGROUND
  This study aimed to clarify the prognostic significance of tumour markers on long-term survival in colorectal peritoneal carcinomatosis (CRPC) following cytoreductive surgery and intraperitoneal chemotherapy.
  
  
  METHODS
  Preoperative serum tumour markers of 164 patients with CRPC were analyzed. Peritoneal cancer index (PCI) was measured and relationship to survival calculated.
  
  
  RESULTS
  Carcinoembryonic antigen (CEA) >6.5 mg/l and cancer antigen 125 (CA125) >16 U/ml remained independent predictors of survival after adjusting for PCI [adjusted hazard ratio (aHR)=2.46, 95% confidence interval (CI)=1.3-4.5, p<0.01 and aHR=2.23, 95% CI=1.21-4.09, p<0.01, respectively]. Patients with high CEA and low CA125 or vice versa had an approximately triple risk of death (HR=3.34, 95% CI=1.21 9.25, p=0.02 and HR=2.76, 95% CI=1.01 7.77, p=0.04, respectively). High CEA with high CA125 produced an additive effect, reflecting a six-fold increase in death (HR=6.57, 95% CI=2.62 13.69, p<0.001, median survival: not reached vs. 22 months).
  
  
  CONCLUSIONS
  Serum CEA and CA125 in patients with CRPC treated with cytoreductive surgery and intraperitoneal chemotherapy convey a negative prognostic effect independently of PCI.
authors.affiliation: Department of Surgery, St. George Hospital, University of New South Wales, Sydney, NSW, Australia Faculty of Medicine, St. George Clinical School, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Ya Ruth
authors.initials: YR
authors.lastname: Huo
authors.affiliation: Department of Surgery, St. George Hospital, University of New South Wales, Sydney, NSW, Australia Faculty of Medicine, St. George Clinical School, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Yeqian
authors.initials: Y
authors.lastname: Huang
authors.affiliation: Cancer Care Centre, St. George Hospital, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Winston
authors.initials: W
authors.lastname: Liauw
authors.affiliation: Department of Surgery, St. George Hospital, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Department of Surgery, St. George Hospital, University of New South Wales, Sydney, NSW, Australia Faculty of Medicine, St. George Clinical School, University of New South Wales, Sydney, NSW, Australia david.morris@unsw.edu.au.
authors.forename: David L
authors.initials: DL
authors.lastname: Morris
mesh_terms: D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000008:administration & dosage / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000378:metabolism / Q000628:therapy*; D065426:Cytoreduction Surgical Procedures; D005260:Female; D006801:Humans; D007263:Infusions, Parenteral; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000378:metabolism / Q000628:therapy*; D011379:Prognosis; D016019:Survival Analysis; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: C097353:AFP protein, human; D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D000509:alpha-Fetoproteins
keywords: CA125; CEA; Colorectal cancer; chemotherapy; prognosis; tumour markers