BJS open · 2026
Preoperative carbohydrate antigen 19-9 as a prognostic biomarker in colorectal cancer with synchronous peritoneal metastasis: multicentre cohort study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеНазвание и аннотация: Перевод в очереди
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Tashiro Keita, Kajiwara Yoshiki, Ueno Hideki, Kobayashi Hirotoshi, Kotake Kenjiro, Sugihara Kenichi, Ajioka Yoichi
Аннотация
BACKGROUND: Currently, no international guidelines recommend carbohydrate antigen 19-9 (CA19-9) as a biomarker in colorectal cancer in clinical practice, although it has been reported that tumour cells with high affinity for peritoneal cells strongly express CA19-9. The aim of this study was to determine the utility of preoperative serum CA19-9 levels in predicting prognosis in patients with colorectal cancer and synchronous peritoneal metastasis.
METHODS: Prognostic analyses were retrospectively performed in patients with colorectal cancer and synchronous peritoneal metastases who received treatment in 16 hospitals between 1991 and 2007 (Cohort 1). The categorization for CA19-9 and carcinoembryonic antigen were established based on the thresholds that minimized Akaike information criterion values for overall survival. A separate validation cohort of patients with synchronous peritoneal metastasis was prospectively registered across 28 institutions between 2012 and 2016 (Cohort 2) to validate these findings.
RESULTS: A total of 689 patients were analysed in Cohort 1 and 144 in the validation Cohort 2. The categorized serum CA19-9 and carcinoembryonic antigen levels were significantly correlated with overall survival (P < 0.001 and P < 0.001, respectively). The median postoperative overall survival was 19.0 months for patients with a preoperative CA19-9 level < 100 U/ml compared with 4.1 months for those with a preoperative CA19-9 level of ≥ 10 000 U/ml. Using multivariable analysis, serum CA19-9, but not carcinoembryonic antigen, was an independent prognostic factor for overall survival. These results were confirmed in Cohort 2, revealing that the prognostic power of CA19-9 was superior to that of carcinoembryonic antigen.
CONCLUSIONS: Preoperative serum CA19-9 outperformed carcinoembryonic antigen as an independent prognostic biomarker in patients with colorectal cancer and peritoneal metastasis.
METHODS: Prognostic analyses were retrospectively performed in patients with colorectal cancer and synchronous peritoneal metastases who received treatment in 16 hospitals between 1991 and 2007 (Cohort 1). The categorization for CA19-9 and carcinoembryonic antigen were established based on the thresholds that minimized Akaike information criterion values for overall survival. A separate validation cohort of patients with synchronous peritoneal metastasis was prospectively registered across 28 institutions between 2012 and 2016 (Cohort 2) to validate these findings.
RESULTS: A total of 689 patients were analysed in Cohort 1 and 144 in the validation Cohort 2. The categorized serum CA19-9 and carcinoembryonic antigen levels were significantly correlated with overall survival (P < 0.001 and P < 0.001, respectively). The median postoperative overall survival was 19.0 months for patients with a preoperative CA19-9 level < 100 U/ml compared with 4.1 months for those with a preoperative CA19-9 level of ≥ 10 000 U/ml. Using multivariable analysis, serum CA19-9, but not carcinoembryonic antigen, was an independent prognostic factor for overall survival. These results were confirmed in Cohort 2, revealing that the prognostic power of CA19-9 was superior to that of carcinoembryonic antigen.
CONCLUSIONS: Preoperative serum CA19-9 outperformed carcinoembryonic antigen as an independent prognostic biomarker in patients with colorectal cancer and peritoneal metastasis.