期刊
INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
卷 36, 期 4, 页码 767-778出版社
SPRINGER
DOI: 10.1007/s00384-020-03828-z
关键词
Colorectal cancer liver metastases; Carbohydrate antigen 19-9; Carcinoembryonic antigen; Hepatectomy; Prognosis
资金
- National Nature Science Foundation of China [81874143, 31971192]
- Beijing Natural Science Foundation [7192035]
Preoperative CA19-9 is a promising predictor of recurrence for CRLM patients undergoing hepatectomy, especially for those with low-level CEA. Patients with high-level CA19-9 have significantly worse 5-year recurrence-free survival and overall survival.
Purpose The role of preoperative carbohydrate antigen 19-9 (CA19-9) in colorectal cancer liver metastases (CRLM) patients is still unclear. The present study aimed to explore the prognostic significance of preoperative CA19-9 in those patients. Methods A total of 691 CRLM patients were included in this study. X-tile analyses were performed to determine the optimal cut-off values of CA19-9 and carcinoembryonic antigen (CEA). Prognostic predictors were identified by multivariate analyses. Results The optimal cut-off values of CA19-9 and CEA for 5-year recurrence-free survival (RFS) were 35.24 U/ml and 20.4 ng/ml, respectively. Patients with high-level CA19-9 had significantly worse RFS and overall survival (OS) than those with low-level CA19-9 (P = 0.001 and P = 0.002, respectively). In addition, patients with high-level CA19-9 had poor RFS and OS (P = 0.028 and P = 0.011, respectively) at low-level CEA. Multivariate analyses confirmed that preoperative CA19-9 was an independent predictor for RFS (hazard ratio [HR] 1.295; 95% confidence interval [CI] 1.043-1.607; P = 0.019) but not for OS (HR 1.213; 95% CI 0.902-1.631; P = 0.201). Conclusion CA19-9 is a promising predictor of recurrence for CRLM patients undergoing hepatectomy, and an effective supplement for patients with low-level CEA.
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