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Preoperative CA19-9: a competitive predictor of recurrence in patients with colorectal cancer liver metastases after hepatectomy

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Abstract

Purpose

The role of preoperative carbohydrate antigen 19-9 (CA19-9) in colorectal cancer liver metastases (CRLM) patients is still unclear. The present study aimed to explore the prognostic significance of preoperative CA19-9 in those patients.

Methods

A total of 691 CRLM patients were included in this study. X-tile analyses were performed to determine the optimal cut-off values of CA19-9 and carcinoembryonic antigen (CEA). Prognostic predictors were identified by multivariate analyses.

Results

The optimal cut-off values of CA19-9 and CEA for 5-year recurrence-free survival (RFS) were 35.24 U/ml and 20.4 ng/ml, respectively. Patients with high-level CA19-9 had significantly worse RFS and overall survival (OS) than those with low-level CA19-9 (P = 0.001 and P = 0.002, respectively). In addition, patients with high-level CA19-9 had poor RFS and OS (P = 0.028 and P = 0.011, respectively) at low-level CEA. Multivariate analyses confirmed that preoperative CA19-9 was an independent predictor for RFS (hazard ratio [HR] 1.295; 95% confidence interval [CI] 1.043–1.607; P = 0.019) but not for OS (HR 1.213; 95% CI 0.902–1.631; P = 0.201).

Conclusion

CA19-9 is a promising predictor of recurrence for CRLM patients undergoing hepatectomy, and an effective supplement for patients with low-level CEA.

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Data availability

All data and material relevant to the study are available from the authors upon request.

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Acknowledgments

The authors thank the National Natural Science Foundation of China (No. 81874143, No. 31971192) and Beijing Natural Science Foundation (No. 7192035) for providing financial support for the study. Special thanks go to Xiu-Jian Ma, MD, for critically revising this paper.

Funding

This study was supported by grants from the National Nature Science Foundation of China (No. 81874143, No. 31971192) and Beijing Natural Science Foundation (No. 7192035).

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Authors and Affiliations

  1. Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Hepatopancreatobiliary Surgery Department I, Peking University Cancer Hospital & Institute, 52 Fucheng Road, Haidian District, Beijing, 100142, China

    Jia-Ming Liu, Yan-Yan Wang, Wei Liu, Da Xu, Kun Wang & Bao-Cai Xing

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  1. Jia-Ming Liu
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  2. Yan-Yan Wang
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  3. Wei Liu
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Contributions

Concept and design: Jia-Ming Liu, Bao-Cai Xing

Data acquisition: Jia-Ming Liu, Yan-Yan Wang, Da Xu, Kun Wang

Data analyses and interpretation: Jia-Ming Liu, Yan-Yan Wang, Wei Liu

Manuscript drafting: Jia-Ming Liu, Da Xu, Yan-Yan Wang

Critical revision of the manuscript for important intellectual content: Jia-Ming Liu, Kun Wang, Bao-Cai Xing

Supervision: Bao-Cai Xing

Corresponding author

Correspondence to Bao-Cai Xing.

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The authors declare that they have no conflict of interest.

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The Ethics Committee of Peking University Cancer Hospital approved this study.

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All materials and data were obtained with agreement from patients and informed consent was signed.

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The approval for publication was given by all co-authors.

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X-tile software, SPSS 23, and GraphPad Prism 8.0.1 are applied for statistical analyses and figure plotting.

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Liu, JM., Wang, YY., Liu, W. et al. Preoperative CA19-9: a competitive predictor of recurrence in patients with colorectal cancer liver metastases after hepatectomy. Int J Colorectal Dis 36, 767–778 (2021). https://doi.org/10.1007/s00384-020-03828-z

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