High Serum CA19-9 Concentration Predicts Poor Prognosis in Elderly Patients with Stage IV Colorectal Cancer

Abstract

Background/Aim: The optimal treatment strategy for elderly patients with stage IV colorectal cancer (CRC) remains controversial due to limited research data. The purpose of this study was to evaluate treatment results and to clarify the prognostic factors, especially poor prognosis factors, in elderly patients with stage IV CRC. Methods: We retrospectively reviewed the data of 82 elderly patients (aged ≥75 years) with stage IV CRC who underwent surgical treatment at our hospital between April 2001 and March 2017. Factors that affected prognosis and the ability to undergo treatment were analyzed via multivariate analysis. Results: The median overall survival (OS) in the patients with high pretreatment serum carbohydrate antigen 19-9 (CA19-9) concentration (> 370 U/mL) was significantly worse than in those with lower serum CA19-9 concentration (0–370 U/mL) (8.5 vs. 19.2 months, p = 0.0059). In univariate analysis, age (≥80 years) (p = 0.014), performance status of 1–3 (p = 0.028), and high pretreatment serum CA19-9 concentration (p = 0.014) were significant prognostic factors for poor OS. By contrast, resection of the primary tumor (p = 0.024), chemotherapy (p < 0.0001), and resection of distant metastasis (p = 0.0005) were significant prognostic factors for favorable OS. Multivariate analysis showed that a high pretreatment serum CA19-9 concentration was an independent prognostic factor for poor OS (p = 0.01). Meanwhile, resection of the primary tumor (p = 0.033), chemotherapy (p < 0.0001), and resection of distant metastasis (p = 0.0008) were prognostic factors for favorable OS. Conclusions: A high pretreatment serum CA19-9 concentration (> 370 U/mL) was a reliable predictive factor for poor prognosis, and aggressive treatments should be performed carefully in these patients. Moreover, various treatments, including surgery and chemotherapy, might improve OS in elderly patients with stage IV CRC.

CA125: A superior prognostic biomarker for colorectal cancer compared to CEA, CA19-9 or CA242

“…CA19-9 is a biomarker most often used in pancreatic ductal adenocarcinoma (PDAC) diagnosis and monitoring [7], but not routinely used or recommended in CRC diagnosis, monitoring, or prognostics. Yet, elevated CA19-9 levels are found in CRC patients with a poor prognosis compared with patients with low CA19-9 levels [14]. We found CA19-9 served as a significant but not independent prognostic tumor marker in CRC, whereas it was previously considered to hold predictive value [8,15].…”

SOX9 promotes epithelial‑mesenchymal transition via the Hippo‑YAP signaling pathway in gastric carcinoma cells

“…Previous studies suggested that the prognosis of patients with cancer is significantly influenced by metastasis (42,43). EMT is known to regulate metastasis and acts as a factor in determining the prognosis of cancer patient (44–46).…”

Novel Prognostic Role of Serum CA19-9 Identified in Colorectal Terminal Tumor Site and Tubular Adenocarcinoma&nbsp;

“…Carbohydrate antigen 19 − 9 (CA19-9), a modi ed Lewis blood group antigen associated with speci c malignancies, increases in patients with gastrointestinal cancers (30). CA19-9 was utilized as sensitive biomarker to evaluate the adenocarcinomas of the colon and rectum, and advance stage colorectal cancer with metastasis (25,(31)(32)(33). However, the correlation between the local expression level of CA19-9 and colorectal terminal tumor sites (sigmoid and rectum) is still unclear.…”