ArticleTranslational cancer research2021
Prognostic value of CEA and CA19-9 in patients with local advanced rectal cancer receiving neoadjuvant chemoradiotherapy, radical surgery and postoperative chemotherapy.
Article in Translational cancer research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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7 citing papers in PubMed, 13 citations in OpenAlex.
- The Role of Baseline PET/CT Parameters in Predicting Treatment Response in Patients with Locally Advanced Rectal Cancer Undergoing Total Neoadjuvant Therapy.Medicina (Kaunas, Lithuania) · 2025Article
- Development and validation of a multi-parametric MRI deep-learning model for preoperative lymphovascular invasion evaluation in rectal cancer.Quantitative imaging in medicine and surgery · 2025Article
- Evaluation of Response to Neoadjuvant Chemoradiotherapy in Locally Advanced Rectal Cancer through Shear-Wave Elastography.Current medical imaging · 2025Observational
- Preoperative prediction of rectal Cancer staging combining MRI deep transfer learning, radiomics features, and clinical factors: accurate differentiation from stage T2 to T3.BMC gastroenterology · 2024Article
- Development and validation of nomograms based on pre-/post-operative CEA and CA19-9 for survival predicting in stage I-III colorectal cancer patients after radical resection.Frontiers in oncology · 2024Article
- Predictive value of apparent diffusion coefficient for neoadjuvant chemotherapy in locally advanced colorectal cancer patients.Journal of gastrointestinal oncology · 2023Article
- Machine learning algorithms to predict atypical metastasis of colorectal cancer patients after surgical resection.Frontiers in surgery · 2022Article
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7 authors at 2 institutions in 1 country.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundWe aim to investigate the prognostic factors and evaluate the role of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) in local advanced rectal cancer (LARC) patients who received neoadjuvant chemoradiotherapy (neo-CRT), radical surgery and postoperative chemotherapy.
methodsIn total, 197 cases of LARC patients who underwent neo-CRT, total mesorectal excision (TME), and adjuvant chemotherapy were recruited. Serum levels of CEA and CA19-9 were detected both at baseline and after neo-chemoradiotherapy. Multivariate analysis was used to assess correlations between levels of CEA and CA19-9 and patients' prognosis (survival, recurrence, and metastasis). Rates of survival, distant metastasis (DM), and local recurrence (LR) were estimated using Kaplan-Meier survival analysis, the log-rank test, and Cox proportional hazards.
resultsThe median follow-up time was 45.3 months, and a cohort of 197 patients was analyzed; 84 (42.6%) patients had elevated baseline CEA levels, 21 (10.7%) patients had elevated baseline CA19-9 levels, and 14 (7.1%) patients had both; 77.4% (65/84) patients with high CEA levels and 76.2% (16/21) with high CA19-9 levels returned to normal after neo-chemoradiotherapy. The Cox regression model suggested that elevated CEA was associated with an increased risk of disease-free survival (DFS) (HR: 2.058, 95% CI: 1.034-4.096, P=0.040) and DM (HR: 2.144, 95% CI: 1.058-4.346, P=0.034). Elevated CA19-9 was identified as an independent prognostic factor, with poorer overall survival (OS) (HR: 2.894, 95% CI: 1.196-7.006, P=0.018) and DFS (HR: 4.533, 95% CI: 2.067-9.940, P<0.001) and increased incidences of LR (HR: 6.139, 95% CI: 1.813-20.783, P=0.004) and DM (HR: 4.052, 95% CI: 1.892-8.678, P<0.001). Besides, combined CEA with CA19-9 was a stronger prognostic predictor. Patients with both high levels of CEA and CA19-9 had the poorest DFS (HR: 8.157, 95% CI: 3.232-20.591, P<0.001) and the highest risk of DM (HR: 8.790, 95% CI: 3.324-23.248, P<0.001).
conclusionsLARC patients with high levels of CEA or/and CA19-9 at initial treatment have a worse prognosis, even after neo-CRT, subsequent radical resection, and adjuvant chemotherapy. These findings suggest that this subset of patients requires more intensive treatment or additional treatment strategies.
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