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High preoperative serum CA19-9 level is predictive of poor prognosis for patients with colorectal liver oligometastases undergoing hepatic resection

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Abstract

Oligometastasis is defined as a transitional state between localized and widespread systemic metastatic cancers. In colorectal cancer, the prognostic factors and prognostic value of preoperative serum carbohydrate antigen 19-9 (CA19-9) and carcinoembryonic antigen (CEA) for patients with colorectal liver oligometastases (CLOM) undergoing hepatic resection have not been well explored. Therefore, the present study included 141 patients with CLOM (≤5 liver metastases) who underwent R0 resection from 2005 to 2012. The association of clinicopathological factors including preoperative CA19-9 and CEA levels with overall survival (OS) was analyzed with univariate and multivariate analyses. Kaplan–Meier analysis showed that patients with high CA19-9 levels tended to have poorer OS than those with low levels (median OS 21.5 vs. 64.0 months, P = 0.002). Preoperative CEA levels were not significantly associated with OS (P > 0.05). Univariate and multivariate analyses demonstrated that larger tumor size of liver metastases (HR 1.911; 95 % CI 1.172–3.114; P = 0.009), bilobar distribution (HR 1.776; 95 % CI 1.097–2.873; P = 0.019), and higher preoperative CA19-9 levels (HR 1.954; 95 % CI 1.177–3.242; P = 0.010) were independent predictors of poor OS for patients with CLOM. Our study identified tumor size, distribution, and preoperative CA19-9 levels as independent prognostic factors for OS of patients with CLOM. In particular, measurement of preoperative CA19-9 levels offers an easy tool that could help identify high-risk patients and aid in improving the management of patients with CLOM.

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Funding

This study was funded in part by grants from the National Natural Science Foundation of China (81101863) and Sun Yat-sen University Clinical Research 5010 Program (No. 2013013).

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    Authors and Affiliations

    1. Department of Colorectal Surgery, Sun Yat-sen University Cancer Center, Guangzhou, China

      Zhenhai Lu, Jianhong Peng, Zhizhong Pan & Desen Wan

    2. Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou, China

      Zhiqiang Wang

    3. Department of Hepatobiliary Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng Road East, Guangzhou, 510060, Guangdong, China

      Yunfei Yuan & Binkui Li

    4. State Key Laboratory of Oncology in South China, Guangzhou, China

      Zhenhai Lu, Jianhong Peng, Zhiqiang Wang, Zhizhong Pan, Yunfei Yuan, Desen Wan & Binkui Li

    5. Collaborative Innovation Center for Cancer Medicine, Guangzhou, China

      Zhenhai Lu, Jianhong Peng, Zhiqiang Wang, Zhizhong Pan, Yunfei Yuan, Desen Wan & Binkui Li

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    1. Zhenhai Lu
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    Correspondence to Binkui Li.

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    All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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    Informed consent was obtained from all individual participants included in the study.

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    Zhenhai Lu, Jianhong Peng, and Zhiqiang Wang have contributed equally.

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    Lu, Z., Peng, J., Wang, Z. et al. High preoperative serum CA19-9 level is predictive of poor prognosis for patients with colorectal liver oligometastases undergoing hepatic resection. Med Oncol 33, 121 (2016). https://doi.org/10.1007/s12032-016-0838-5

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    • DOI: https://doi.org/10.1007/s12032-016-0838-5

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