Evidence map›Paper›PMID 25651978›Full record

ArticleClinical and translational gastroenterology2015

Elevated CA19-9 Is Associated With Increased Mortality In A Prospective Cohort Of Hepatocellular Carcinoma Patients.

Christine C Hsu, Abhishek Goyal, Alina Iuga, Saravanan Krishnamoorthy, Valerie Lee, Elizabeth C Verna, Shuang Wang, Fei-Na Chen, Rosa Rodriguez, Jean Emond and 5 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Clinical and translational gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
1.1field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 38 citations in OpenAlex.

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  15. Oncology letters · 2020
    Article
  16. Preoperative Carbohydrate Antigen 19-9: Its Neglected Role in Alpha-Fetoprotein-Negative Hepatocellular Carcinoma Patients.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017
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  17. Article
  18. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors at 2 institutions in 2 countries.

Christine C HsuDepartments of Medicine, Columbia University, New York, New York, USA.
Abhishek GoyalDepartment of Epidemiology, Columbia University, New York, New York, USA.
Alina IugaDepartment of Pathology and Cell Biology, Columbia University, New York, NY, USA.
Saravanan KrishnamoorthyDepartment of Radiology, Columbia University, New York, New York, USA.
Valerie LeeDepartments of Medicine, Columbia University, New York, New York, USA.
Elizabeth C Verna1] Departments of Medicine, Columbia University, New York, New York, USA [2] Department of Surgery, Columbia University, New York, New York, USA.
Shuang WangDepartment of Biostatistics, Columbia University, New York, New York, USA.
Fei-Na ChenSchool of Medicine, China Medical University and Hospital, Taichung, Taiwan.
Rosa RodriguezDepartments of Medicine, Columbia University, New York, New York, USA.
Jean EmondDepartment of Surgery, Columbia University, New York, New York, USA.
Paul BerkDepartments of Medicine, Columbia University, New York, New York, USA.
Jay LefkowitchDepartment of Pathology and Cell Biology, Columbia University, New York, NY, USA.
Lorna Dove1] Departments of Medicine, Columbia University, New York, New York, USA [2] Department of Surgery, Columbia University, New York, New York, USA.
Robert S Brown1] Departments of Medicine, Columbia University, New York, New York, USA [2] Department of Surgery, Columbia University, New York, New York, USA.
Abby B Siegel1] Departments of Medicine, Columbia University, New York, New York, USA [2] Department of Surgery, Columbia University, New York, New York, USA.
Columbia University · USChina Medical University Hospital · TW

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesHepatocellular carcinoma (HCC) is the third leading cause of cancer-related deaths worldwide. CA19-9 is a glycoprotein that predicts poor prognosis in pancreatic and biliary malignancies. We evaluated it as a prognostic biomarker for patients with HCC.

methodsWe prospectively enrolled 145 patients with HCC, diagnosed using American Association for Study of Liver Diseases criteria, between October 2008 and November 2012. We examined whether baseline serum CA19-9 levels predicted overall survival. We also examined immunostains of hepatic resections and explants of patients with elevated and normal serum CA19-9.

resultsIn a cohort of predominantly hepatitis C and B patients, CA19-9 ≥100 U/ml was associated with a 2.7-fold increased mortality (hazard ratio (HR): 2.72; 95% confidence interval (CI): 1.52-4.88, P<0.001). It remained a significant predictor (HR: 2.58; 95% CI: 1.41-4.72, P=0.002) in a multivariable model adjusted for Child-Pugh score, alpha-fetoprotein, Barcelona Clinic Liver Cancer stage, and Model for End-Stage Liver Disease. CA19-9 immunohistochemistry performed on a subset of liver resection and explant specimens showed increased CA19-9 immunostaining of non-tumor liver parenchyma in patients with elevated serum CA19-9. It also showed staining of native and reactive bile ducts, and of progenitor-like cells at the periphery of cirrhotic nodules.

conclusionsElevated serum CA19-9 ≥100 U/ml is an independent predictor of poor overall survival in this hypothesis-generating study. The unfavorable prognosis seen with elevated serum levels may be related to progenitor-like cells in the non-tumor liver.

Identifiers

PMID25651978
PMCPMC4418494
OpenAlexW1979584890

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.