Does Serum CA19-9 Play a Practical Role in the Management of Patients With Colorectal Cancer?

Abstract

We could not find clinical significance to support the use of CA19-9 to predict the prognosis and detect recurrence of colorectal cancer. Because of this, we do not recommend routine use of CA19-9 in staging and surveillance of colorectal cancer patients.

Increase in both CEA and CA19-9 in sera is an independent prognostic indicator in colorectal carcinoma

“…Moreover among the recent investigations, Morita et al [11] mentioned that only preoperative elevation of CEA proved to be significantly correlated with poor prognosis by both univariate and multivariate analysis and emphasized that CA19-9 could not be used to predict the prognosis. Nakagoe et al [5] reported that preoperative serum elevation of CA19-9 was an independent predictor of subsequent tumor recurrence of patients with nodenegative colorectal carcinoma who had been treated with curative resection.…”

“…Hence there might still be clinical points concerned with these classical tumor markers in colorectal carcinoma left to be resolved. Indeed, recently there have been some sophisticated investigations regarding the clinical significance of these tumor markers in colorectal carcinoma [5,9,11].…”

Preoperative serum carbohydrate antigen 125 level is an independent negative prognostic marker for overall survival in colorectal cancer

“…Its sensitive is lower than that of CEA in detecting CRC. Morita et al [13] evaluated the role of serum CA19-9 in patients with CRC; the results showed that the CA19-9 level was not a predictor of prognosis. Papk et al [14] found that patients with high preoperative serum CA19-9 levels ([37.0 U/ml) were significantly more likely to show lymphatic invasion, perineural invasion, more advanced tumor stage, and recurrence than patients with normal preoperative serum CA19-9 levels.…”

“…Its usefulness in CRC has been explored extensively [13,[15][16][17]. Park et al [15] evaluated preoperative serum CEA in patients with CRC, the results showed that patients with high preoperative serum CEA levels ([7.0 ng/ml) were significantly more likely to have perineural invasion, more aggressive tumor stage, and tumor recurrence than were patients with normal preoperative serum CEA.…”

Diagnostic Value of Preoperative Serum Carcinoembryonic Antigen and Carbohydrate Antigen 19-9 in Colorectal Cancer

“…It remains unclear whether monitoring tumour markers has any clinical benefit in the management of colorectal cancer patients 13 . Serum cea is not recommended as a screening test, but it might be ordered preoperatively if it can assist in staging and in planning treatment strategies.…”