Prognostic value of carcinoembryonic antigen (CEA) and CA 19-9 levels in patients with obstructive colorectal cancer treated with a self-expandable metallic stent and curative surgery

• DOI: 10.1007/s00595-024-02943-6
• Publication Date: 2024-10-15T09:02:14Z
• Authors: Ryuichiro Sato; Masaya Oikawa; Tetsuya Kakita; Tomoya Abe; Naoya Akazawa; Haruka Okano; Kei Ito; Takashi Tsuchiya
• Keywords: Carcinoembryonic antigen; Surgical oncology

The importance of tumor markers is well established; yet little is known about their prognostic value for patients with obstructive colorectal cancer (OCRC). We investigated the clinical significance of carcinoembryonic antigen (CEA) and CA 19-9 levels in patients with non-metastatic OCRC, who underwent insertion of a self-expandable metallic stent and curative surgery.Clinical data on 91 patients with OCRC were analyzed retrospectively to evaluate the associations of preoperative serum values of tumor makers with short- and long-term outcomes.The 91 patients comprised 53 men and 38 women, with a median age of 71 years. Twelve patients had an elevated preoperative CA 19-9 level. Multivariate analyses revealed that an elevated CA 19-9 level was independently associated with poor disease-free survival (DFS) [hazard ratio (HR) = 4.57, 95% confidence interval (CI) 2.06-10.14, P < 0.001] and overall survival (HR = 4.06, 95% CI 1.46-11.24, P = 0.007). A CEA level > 5 ng/ml had no prognostic value, whereas a CEA level > 10.8 ng/ml was significantly associated with worse DFS (P = 0.032).Measuring the CA 19-9 level concomitantly with the CEA level for patients with advanced CRC, including OCRC, may provide a valuable means to improve prognostication.