Preoperative Carbohydrate Antigen 19-9 Levels Can Predict Stage and Survival Rate in Patients with Colorectal Cancer

Moon, Soo Young; Cha, Jae Myung; Lee, Joung Il; Joo, Kwang Ro; Shin, Hyun Phil; Park, Jae Jun; Jeon, Jung Won; Lim, Jun Uk; Jun, Seung Jung; Seo, Yoon Jong; Lee, Chi Hoon

Abstract

BACKGROUND/AIMS
The purpose of this study was to determine whether preoperative carbohydrate antigen 19-9 (CA 19-9) levels can predict the stage of diseases or survival rate in patients with resectable colorectal cancer (CRC).
METHODS
A total of 247 patients who underwent curative resections at Kyung Hee University Hospital at Gangdong between 2006 and 2011 were enrolled. We investigated the correlations of preoperative serum levels of CA19-9 with clinicopathological features of CRC. Receiver operative curve was constructed for evaluating the efficiency of the serum CA 19-9 levels in the stratifying stage of CRC. Survival analysis was performed with Kaplan-Meire method and log-rank test. Cox regression analysis was used for the multivariate analysis for survival.
RESULTS
Abnormal level of serum CA 19-9 (>37 IU/mL) were associated with advanced T stage (P<0.001), N stage (P=0.002) and TNM stage (P<0.001) in patients with resectable CRC. Furthermore, abnormal level of serum CA 19-9 were related with vascular invasion (P=0.002) and lymphatic invasion (P=0.026). The area under the curve was 0.75 (95% confidence interval [CI] 0.67-0.83) for T4 stage CRC and 0.680 (95% CI 0.61-0.75) for TNM stage III CRC. In patients with TNM stage III CRC, a preoperative CA 19-9 higher than 60 IU/mL (P=0.033) and presence of vascular invasion (P=0.002) were identified as significant predictors of survival rate on multivariate analysis.
CONCLUSIONS
In patients with resectable CRC, preoperative CA 19-9 correlates with T stage, N stage and TNM stage of disease. Serum CA 19-9 >60 U/mL was an independent predictor of survival rate in the patients with TNM stage III CRC.