Prognostic value of preoperative CEA and CA 19-9 levels in patients with colorectal cancer

Abstract

Aims: This study evaluated the prognostic value of the preoperative CEA and CA 19-9 levels on the survival time and TNM staging in patients with colorectal cancer.

Methodology: We retrospectively analyzed 172 patients who underwent potentially curative resection of colorectal cancer (TNM I-III) between 2002 and 2007. Clinical data were obtained from medical charts, including age, gender, tumor location, TNM stage, mortality, follow-up duration, and preoperative CEA and CA 19-9 levels. A CEA > or = 5ng/mL was defined as abnormal (CEA+), while the cutoff for the CA19-9 was set at 37U/mL (CA19-9+). Patients were categorized into Groups I-IV according to the preoperative serum CEA and CA 19-9 levels [CEA/ CA 19-9: (-/-), (+/-), (-/+), and (+/+)].

Results: Follow-up was longest for Group I (p<0.001). Mortality rates were higher in Groups V (p<0.001) and II (p<0.008). On comparing patients according to CEA levels, survival was longer in the CEA-negative group (p=0.0001). On comparison according to CA 19-9 levels, survival was greater in the CA 19-9-negative group (p=0.0001). While CEA (p<0.016) and CA 19-9 (p<0.001) were independent prognostic factors according to the logistic regression analysis, TNM (p=0.002), CEA (p<0.001), and CA 19-9 (p<0.001) were prognostic factors in the ROC curve analysis.

Conclusions: Colorectal cancer patients with elevated levels of both CEA and CA 19-9 have a significantly poorer prognosis than those with normal levels of these tumor markers.