The Prognostic Value of Preoperative Serum CEA and CA19-9 Values in Stage I-III Colorectal Cancer

Background/Aims: There is disagreement about the prognostic value of serum carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in patients who have stage I-III colorectal cancer. Therefore, we investigated the relationship between pre-operative serum CEA and CA19-9 levels and clinical outcome in patients with this disease. Methodology: The study included 724 patients who had received radical resection for stage I-III colorectal cancer in Fudan University Shanghai Cancer Center. We retrospectively investigated the relationship between patients' characteristics and survival, using univariate and multivariate analyses. In multivariate analysis, factors found significant in the univariate analysis were compared with patients' outcomes. Results: In univariate analysis, differentiation (P <0.001), depth of invasion (P <0.001), number of lymph node metastases (P <0.001), and elevated levels of CEA (P <0.001) and CA19-9 (P <0.001) were closely correlated with patients' survival. In multivariate analysis, the number of lymph node metastases (P <0.001), preoperative CA19-9 (P = 0.015) and CEA (P = 0.028) values, differentiation (p=0.040) and depth of invasion (p=0.039) were independent prognostic factors for survival. Conclusions: Preoperative CA19-9 and CEA have independent prognostic values in stage I-III colorectal cancer. Elevation of and both CEA and CA19-9 values predicted the worst outcome.