Ya Ruth Huo1, Yeqian Huang1, Winston Liauw2, Jing Zhao3, David L Morris4. 1. Department of Surgery, St. George Hospital, University of New South Wales, Sydney, NSW, Australia Faculty of Medicine, St. George Clinical School, University of New South Wales, Sydney, NSW, Australia. 2. Cancer Care Centre, St. George Hospital, University of New South Wales, Sydney, NSW, Australia. 3. Department of Surgery, St. George Hospital, University of New South Wales, Sydney, NSW, Australia. 4. Department of Surgery, St. George Hospital, University of New South Wales, Sydney, NSW, Australia Faculty of Medicine, St. George Clinical School, University of New South Wales, Sydney, NSW, Australia david.morris@unsw.edu.au.
Abstract
BACKGROUND: This study aimed to clarify the prognostic significance of tumour markers on long-term survival in colorectal peritoneal carcinomatosis (CRPC) following cytoreductive surgery and intraperitoneal chemotherapy. PATIENTS AND METHODS: Preoperative serum tumour markers of 164 patients with CRPC were analyzed. Peritoneal cancer index (PCI) was measured and relationship to survival calculated. RESULTS: Carcinoembryonic antigen (CEA) >6.5 mg/l and cancer antigen 125 (CA125) >16 U/ml remained independent predictors of survival after adjusting for PCI [adjusted hazard ratio (aHR)=2.46, 95% confidence interval (CI)=1.3-4.5, p<0.01 and aHR=2.23, 95% CI=1.21-4.09, p<0.01, respectively]. Patients with high CEA and low CA125 or vice versa had an approximately triple risk of death (HR=3.34, 95% CI=1.21 9.25, p=0.02 and HR=2.76, 95% CI=1.01 7.77, p=0.04, respectively). High CEA with high CA125 produced an additive effect, reflecting a six-fold increase in death (HR=6.57, 95% CI=2.62 13.69, p<0.001, median survival: not reached vs. 22 months). CONCLUSION: Serum CEA and CA125 in patients with CRPC treated with cytoreductive surgery and intraperitoneal chemotherapy convey a negative prognostic effect independently of PCI. Copyright
BACKGROUND: This study aimed to clarify the prognostic significance of tumour markers on long-term survival in colorectal peritoneal carcinomatosis (CRPC) following cytoreductive surgery and intraperitoneal chemotherapy. PATIENTS AND METHODS: Preoperative serum tumour markers of 164 patients with CRPC were analyzed. Peritoneal cancer index (PCI) was measured and relationship to survival calculated. RESULTS:Carcinoembryonic antigen (CEA) >6.5 mg/l and cancer antigen 125 (CA125) >16 U/ml remained independent predictors of survival after adjusting for PCI [adjusted hazard ratio (aHR)=2.46, 95% confidence interval (CI)=1.3-4.5, p<0.01 and aHR=2.23, 95% CI=1.21-4.09, p<0.01, respectively]. Patients with high CEA and low CA125 or vice versa had an approximately triple risk of death (HR=3.34, 95% CI=1.21 9.25, p=0.02 and HR=2.76, 95% CI=1.01 7.77, p=0.04, respectively). High CEA with high CA125 produced an additive effect, reflecting a six-fold increase in death (HR=6.57, 95% CI=2.62 13.69, p<0.001, median survival: not reached vs. 22 months). CONCLUSION: Serum CEA and CA125 in patients with CRPC treated with cytoreductive surgery and intraperitoneal chemotherapy convey a negative prognostic effect independently of PCI. Copyright