title: High preoperative serum CA19-9 level is predictive of poor prognosis for patients with colorectal liver oligometastases undergoing hepatic resection.
abstract: Oligometastasis is defined as a transitional state between localized and widespread systemic metastatic cancers. In colorectal cancer, the prognostic factors and prognostic value of preoperative serum carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) for patients with colorectal liver oligometastases (CLOM) undergoing hepatic resection have not been well explored. Therefore, the present study included 141 patients with CLOM (≤5 liver metastases) who underwent R0 resection from 2005 to 2012. The association of clinicopathological factors including preoperative CA19-9 and CEA levels with overall survival (OS) was analyzed with univariate and multivariate analyses. Kaplan-Meier analysis showed that patients with high CA19-9 levels tended to have poorer OS than those with low levels (median OS 21.5 vs. 64.0 months, P = 0.002). Preoperative CEA levels were not significantly associated with OS (P > 0.05). Univariate and multivariate analyses demonstrated that larger tumor size of liver metastases (HR 1.911; 95 % CI 1.172-3.114; P = 0.009), bilobar distribution (HR 1.776; 95 % CI 1.097-2.873; P = 0.019), and higher preoperative CA19-9 levels (HR 1.954; 95 % CI 1.177-3.242; P = 0.010) were independent predictors of poor OS for patients with CLOM. Our study identified tumor size, distribution, and preoperative CA19-9 levels as independent prognostic factors for OS of patients with CLOM. In particular, measurement of preoperative CA19-9 levels offers an easy tool that could help identify high-risk patients and aid in improving the management of patients with CLOM.
authors.affiliation: Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in South China, Guangzhou, China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Zhenhai
authors.initials: Z
authors.lastname: Lu
authors.affiliation: Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in South China, Guangzhou, China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Jianhong
authors.initials: J
authors.lastname: Peng
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in South China, Guangzhou, China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Zhiqiang
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in South China, Guangzhou, China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Zhizhong
authors.initials: Z
authors.lastname: Pan
authors.affiliation: Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China.|State Key Laboratory of Oncology in South China, Guangzhou, China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Yuan
authors.affiliation: Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China.|State Key Laboratory of Oncology in South China, Guangzhou, China.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, China.
authors.forename: Desen
authors.initials: D
authors.lastname: Wan
authors.affiliation: Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China. libinkui@mail.sysu.edu.cn.|State Key Laboratory of Oncology in South China, Guangzhou, China. libinkui@mail.sysu.edu.cn.|Collaborative Innovation Center for Cancer Medicine, Guangzhou, China. libinkui@mail.sysu.edu.cn.
authors.forename: Binkui
authors.initials: B
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D014408:Biomarkers, Tumor / Q000097:blood; D018395:CA-19-9 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D057234:Preoperative Period; D011379:Prognosis; D055815:Young Adult
chemical_list: D000970:Antineoplastic Agents; D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen
keywords: CA19-9; Colon cancer; Hepatectomy; Oligometastasis; Prognosis