Ryosuke Okamura1, Suguru Hasegawa2, Koya Hida2, Nobuaki Hoshino2, Kenji Kawada2, Kenichi Sugihara3, Yoshiharu Sakai2. 1. Department of Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-Cho, Sakyo-ku, Kyoto, Japan. rokamura@kuhp.kyoto-u.ac.jp. 2. Department of Surgery, Kyoto University Hospital, 54 Shogoin-Kawahara-Cho, Sakyo-ku, Kyoto, Japan. 3. Tokyo Medical and Dental University, Tokyo, Japan.
Abstract
BACKGROUND: The serum carcinoembryonic antigen (CEA) test is mainly used for postoperative surveillance of colorectal cancer patients in Western and Japanese guidelines, but evidence to support the use of CA19-9 is scarce. METHODS: We analyzed the cohort data from 22 institutions of the Japanese Study Group for Postoperative Follow-up of Colorectal Cancer. Patients who had undergone curative surgery for primary colorectal cancer (pathological stage I-III) between 1997 and 2006 were eligible for analysis. Sensitivities of CEA and CA19-9 at the time of recurrence and the contribution of CA19-9 to detecting recurrences were assessed. RESULTS: A total of 17,833 patients were eligible, and the overall recurrence rate was 18 %. The sensitivity of CA19-9 in detecting recurrence was lower than that of CEA (29 vs. 57 %). Among patients with recurrence, recurrences were first suspected in 96 % using standard surveillance modalities (CEA elevation, CT scan, clinic visit, and colonoscopy), whereas recurrences were suspected because of CA19-9 elevation in an estimated 1.3 % of patients. With regard to prognosis after recurrences, the sensitivity of CA19-9 was lower than that of CEA in the detection of surgically treatable recurrences (22 vs. 49 %). In terms of overall survival after recurrences, CA19-9 and CEA had almost comparable hazard ratios (1.66 and 1.48, respectively). CONCLUSIONS: Our data suggested that the sensitivity of serum CA19-9 test is low, and that adding it to the current standard surveillance strategies is not beneficial.
BACKGROUND: The serum carcinoembryonic antigen (CEA) test is mainly used for postoperative surveillance of colorectal cancerpatients in Western and Japanese guidelines, but evidence to support the use of CA19-9 is scarce. METHODS: We analyzed the cohort data from 22 institutions of the Japanese Study Group for Postoperative Follow-up of Colorectal Cancer. Patients who had undergone curative surgery for primary colorectal cancer (pathological stage I-III) between 1997 and 2006 were eligible for analysis. Sensitivities of CEA and CA19-9 at the time of recurrence and the contribution of CA19-9 to detecting recurrences were assessed. RESULTS: A total of 17,833 patients were eligible, and the overall recurrence rate was 18 %. The sensitivity of CA19-9 in detecting recurrence was lower than that of CEA (29 vs. 57 %). Among patients with recurrence, recurrences were first suspected in 96 % using standard surveillance modalities (CEA elevation, CT scan, clinic visit, and colonoscopy), whereas recurrences were suspected because of CA19-9 elevation in an estimated 1.3 % of patients. With regard to prognosis after recurrences, the sensitivity of CA19-9 was lower than that of CEA in the detection of surgically treatable recurrences (22 vs. 49 %). In terms of overall survival after recurrences, CA19-9 and CEA had almost comparable hazard ratios (1.66 and 1.48, respectively). CONCLUSIONS: Our data suggested that the sensitivity of serum CA19-9 test is low, and that adding it to the current standard surveillance strategies is not beneficial.
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Authors: Govand Qader; Mukhlis Aali; Shukur W Smail; Kazhan Mahmood; Bestoon Hasan; Karwan M-Amen; Dlzar Bayz Rahman; Fikry A Qadir; Dara K Mohammad; Hastyar H Najmuldeen; Fryad Majeed Rahman; Seepal Ibrahim Ahmad; Nergz S Salih; Zainab M Khdhr; Bushra A Mohammed; Asuda M Majeed; Xanda M Hasan; Bushra H Khidhir; Eman S Muhammad; Bahar A Muhamadsalih; Simav K Hasan; Aram J Hamad; Zahra K Esmail; Chra M Ismael; Shan M Husaen; Chiavan A Abdulla; Bashdar M Hussen; Zjwan Housein; Mudhir Shekha; Abbas Salihi Journal: Asian Pac J Cancer Prev Date: 2021-01-01