Preoperative Serum Markers Prognostic Evaluation in Colon Cancer Patients

Aim: Demonstrate that preoperative tumor markers are prognostic factor in colon rectal cancer and their high levels are correlated with bad prognosis.Methods: We retrospectively analyzed two hundred and thirty-one patients affected by colorectal cancer who underwent radical surgery between January 2012 and August 2016 from a prospectively collected database. The study group consisted of 224 patients: 132 men and 92 women. Demographic details, surgical procedure, histopathologic diagnosis, and survival data were prospectively collected and retrospectively reviewed for this study. Normal cut off values for Carcinoembryonic antigen (CEA) and Carbohydrate Antigen 19.9 (CA 19.9) were respectively 5 ng/ml and 35 UI/ml. A P-value<0.05 was deemed to be statistically significant.Results: Tumor location was 94 times on ascending colon (42%), 13 on transverse colon (5.8%), 77 on descending colon (34.4%) and 40 on rectum (17.8%). All tumors were histologically diagnosed as adenocarcinoma of the colon-rectum and staged according to the TNM staging system. Preoperative serum CEA level was significantly associated only with T stage and serum albumin level; whereas there were no statistically significant differences between preoperative serum CA19.9 and patients’ clinical pathologic characteristics. Overall survival (OS) and disease-free survival (DFS) showed a statistically significant difference in the two groups of patients who are dichotomized according to the normal cut-off value of CEA and Ca 19.9. At the multivariate analysis both preoperative CEA and Ca 19.9 resulted as independent prognostic factor for survival with a p<0.05.Conclusion: These two tumor markers could have a role as prognostic factors leading to a stricter postsurgical follow up in those patients with elevated preoperative values.Core tip: Preoprative measurement of Cea and Ca19.9 is a cheap and routine exam. Their role could help to identify patients with poor prognosis in the preoperative period and to strictly follow up them in the post-surgical setting.