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Original article

Prognostic relevance of preoperative CA 19-9 values in stage III rectal adenocarcinoma: retrospective analysis and clinical implications

By
Edin Hodžić Orcid logo ,
Edin Hodžić
Contact Edin Hodžić

Clinic for General and Abdominal Surgery, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Sadat Pušina ,
Sadat Pušina

Clinic for General and Abdominal Surgery, Clinical Centre of the University of Sarajevo, Sarajevo,

Adi Mulabdić ,
Adi Mulabdić

Clinic for General and Abdominal Surgery, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Mirhan Salibašić ,
Mirhan Salibašić

Clinic for General and Abdominal Surgery, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Emsad Halilović ,
Emsad Halilović

Clinic for General and Abdominal Surgery, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Mujo Kadrić
Mujo Kadrić

Clinic for Oncology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Abstract

Aim
To investigate prognostic significance of preoperative levels of the Carbohydrate anti-gen 19-9 (CA 19-9) in patients with stage III rectal adenocarcinoma who underwent a treatment at the Clinical Centre of the University of Sarajevo.
Methods
A retrospective cohort study included 84 patients who underwent radical anterior rectal resection due to grade III rectal adenocarcinoma, followed by adjuvant chemotherapy according to the FOLFOX protocol (Oxaliplatin, Leucovorin, 5-Fluorouracil (5-FU)). The patients were divided into two groups according to CA 19-9 values (≥27 U/mL and <27 U/mL, respectively). 
Results
High pre-operative CA 19-9 values predicted an increased probability of postoperative metastases, especially liver, lung and abdominopelvic metastases, as well as three-year disease-free survival (3Y-DFS) and three-year overall survival (3Y-OS). The 3Y-DFS rate for patients with high CA 19-9 was 64.5%, while for those with low CA 19-9 it was 87.2%. The 3Y-OS rate for patients with high CA 19-9 was 89.8%, while for those with low CA 19-9 it was 65.7%. Univariate and multivariate regression analysis confirmed that a high level of CA 19-9 is an independent predictor for DFS and OS shorter than three years.
Conclusion Pre-operatively elevated values of CA 19-9 in rectal adenocarcinoma have a significant role in predicting the outcome in patients with stage III rectal adenocarcinoma.

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No specific funding was received for this study.

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