Asian Pacific Journal of Cancer Prevention

Asian Pacific Journal of Cancer Prevention (아시아태평양암예방학회)
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Carbohydrate Antigen 19-9 Levels Associated with Pathological Responses to Preoperative Chemoradiotherapy in Rectal Cancer

  • Yeo, Seung-Gu (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center) ;
  • Kim, Dae Yong (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center) ;
  • Kim, Tae Hyun (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center) ;
  • Kim, Sun Young (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center) ;
  • Baek, Ji Yeon (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center) ;
  • Chang, Hee Jin (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center) ;
  • Park, Ji Won (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center) ;
  • Oh, Jae Hwan (Center for Colorectal Cancer, Research Institute and Hospital, National Cancer Center)
  • Published : 2014.07.15
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Abstract

Purpose: To investigate whether pretreatment serum carbohydrate antigen 19-9 (CA 19-9) levels are associated with pathological responses to preoperative chemoradiotherapy (CRT) in patients with rectal cancer. Materials and Methods: In total, 260 patients with locally advanced rectal cancer (cT3-4NanyM0) who underwent preoperative CRT and radical surgery were analyzed retrospectively. CRT consisted of 50.4 Gy pelvic radiotherapy and concurrent chemotherapy. Radical surgery was performed at a median of 7 weeks after CRT completion. Pathological CRT response criteria included downstaging (ypStage 0-I) and ypT0-1. A discrimination threshold of CA 19-9 level was determined using a receiver operating characteristics analysis. Results: The median CA 19-9 level was 8.0 (1.0-648.0) U/mL. Downstaging occurred in 94 (36.2%) patients and ypT0-1 in 50 (19.2%). The calculated optimal threshold CA 19-9 level was 10.2 U/mL for downstaging and 9.0 U/mL for ypT0-1. On multivariate analysis, CA 19-9 (${\leq}9.0U/mL$) was significantly associated with downstaging (odds ratio, 2.089; 95% confidence interval, 1.189-3.669; P=0.010) or ypT0-1 (OR, 2.207; 95%CI, 1.079-4.512; P=0.030), independent of clinical stage or carcinoembryonic antigen. Conclusions: This study firstly showed a significant association of pretreatment serum CA 19-9 levels with pathological CRT responses of rectal cancer. The CA 19-9 level is suggested to be valuable in predicting CRT responses of rectal cancer cases before treatment.

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References

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