Annals of Surgical Oncology

, Volume 9, Issue 10, pp 961–967

Prognostic value of baseline and serial carcinoembryonic antigen and carbohydrate antigen 19.9 measurements in patients with pseudomyxoma peritonei treated with cytoreduction and hyperthermic intraperitoneal chemotherapy

  • S. van Ruth
  • A. A. M. Hart
  • J. M. G. Bonfrer
  • V. J. Verwaal
  • F. A. N. Zoetmulder
Original Articles

Abstract

Background

Tumor markers are useful for diagnosis and follow-up. We studied the prognostic value of baseline and serial carcinembryonic antigen (CEA) and carbohydrate antigen 19.9 (CA 19.9) measurements in patients with pseudomyxoma peritonei treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy (HIPEC).

Methods

Sixty-three patients with pseudomyxoma peritonei were treated with cytoreductive surgery and HIPEC. The tumor markers CEA and CA19.9 were collected before therapy and at 3-month intervals during follow-up.

Results

Preoperative CEA and CA19.9 levels were increased in, respectively, 75% and 58% of the patients. Baseline tumor marker values were related to the extent of tumor. Immediately after HIPEC, both tumor markers decreased markedly (P<.0001). CA19.9 was shown to be a more useful tumor marker than CEA for follow-up. During follow-up, a high absolute CA19.9 level (P=.0005) was predictive for imminent recurrence. Patients who never attained a normal CA19.9 level showed a higher recurrence rate at 1 year (53%; SE, 15%), in comparison to patients with did so (6%; SE 4%). The median lead time of increased CA19.9 to recurrence was 9 months.

Conclusions

The measurement of the tumor marker CA19.9 is useful in evaluating therapy in patients with pseudomyxoma peritonei treated with cytoreductive surgery and HIPEC. CA19.9 is a prognostic factor for predicting recurrent disease.

Key Words

CEA antigen CA19.9 antigen Prognostic value Pseudomyxoma peritonei Recurrence HIPEC 

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Copyright information

© The Society of Surgical Oncology, Inc 2002

Authors and Affiliations

  • S. van Ruth
    • 3
  • A. A. M. Hart
    • 1
  • J. M. G. Bonfrer
    • 2
  • V. J. Verwaal
    • 3
  • F. A. N. Zoetmulder
    • 3
  1. 1.Department of RadiotherapyThe Netherlands Cancer Institute/Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
  2. 2.Department of Clinical ChemistryThe Netherlands Cancer Institute/Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands
  3. 3.Department of Surgical OncologyThe Netherlands Cancer Institute/Antoni van Leeuwenhoek HospitalAmsterdamThe Netherlands

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