TY - JOUR
T1 - Precystectomy serum levels of carbohydrate antigen 19-9, carbohydrate antigen 125, and carcinoembryonic antigen
T2 - Prognostic value in invasive urothelial carcinoma of the bladder
AU - Ahmadi, Hamed
AU - Djaladat, Hooman
AU - Cai, Jie
AU - Miranda, Gus
AU - Daneshmand, Siamak
PY - 2014/7
Y1 - 2014/7
N2 - Objectives: To evaluate the prognostic value of precystectomy carbohydrate antigen 19-9 (CA 19-9), carbohydrate antigen 125 (CA 125), and carcinoembryonic antigen (CEA) levels in invasive urothelial carcinoma of the bladder (UCB). Methods and materials: Preoperatively collected serum samples from patients with invasive UCB who underwent radical cystectomy between 2004 and 2009 were used to measure CA 19-9, CA 125, and CEA levels. Laboratory cutoff points were used to define elevated marker levels (CA 19-9>37. U/ml, CA 125>35. U/ml, and CEA>3.8. U/ml). The Cox regression model was used to identify independent predictors of recurrence-free survival (RFS) and overall survival (OS). Results: A total of 186 patients with the mean age of 69 years (range: 36-89) and median follow-up of 4 years (range: 0.1-7.2) were included in the study. Overall, 94 (51%) patients had pathologic organ-confined disease (≤T2) and 92 (49%) had pathologic locally advanced UCB (pT3-T4 or positive lymph node or both). The mean CA 19-9, CA 125, and CEA levels were 11.6. U/ml (range:<0.6-111), 11.5. U/ml (range: 3-56), and 2.2. ng/ml (range: 0.3-30.2), respectively. Levels of CA 19-9, CEA, and CA 125 were elevated in 7 (3%), 25 (13%), and 3 (1%) patients, respectively. Median 3-year RFS and OS were 72%. Using the multivariate Cox regression model, elevated levels of CA 19-9 and CEA were found to be independent predictors of worse 3-year OS (hazard ratio [HR] = 2.7, P = 0.05 and HR = 2, P = 0.03, respectively), and an elevated level of CA 19-9 was an independent predictor of worse 3-year RFS (HR = 2.8, P = 0.05). Precystectomy CA 125 level was not associated with oncological outcome. Conclusions: Elevated precystectomy serum levels of CA 19-9 and CEA are independent predictors of worse oncological outcome in patients with invasive UCB. Further studies are needed to elucidate the role of these markers in the management of UCB.
AB - Objectives: To evaluate the prognostic value of precystectomy carbohydrate antigen 19-9 (CA 19-9), carbohydrate antigen 125 (CA 125), and carcinoembryonic antigen (CEA) levels in invasive urothelial carcinoma of the bladder (UCB). Methods and materials: Preoperatively collected serum samples from patients with invasive UCB who underwent radical cystectomy between 2004 and 2009 were used to measure CA 19-9, CA 125, and CEA levels. Laboratory cutoff points were used to define elevated marker levels (CA 19-9>37. U/ml, CA 125>35. U/ml, and CEA>3.8. U/ml). The Cox regression model was used to identify independent predictors of recurrence-free survival (RFS) and overall survival (OS). Results: A total of 186 patients with the mean age of 69 years (range: 36-89) and median follow-up of 4 years (range: 0.1-7.2) were included in the study. Overall, 94 (51%) patients had pathologic organ-confined disease (≤T2) and 92 (49%) had pathologic locally advanced UCB (pT3-T4 or positive lymph node or both). The mean CA 19-9, CA 125, and CEA levels were 11.6. U/ml (range:<0.6-111), 11.5. U/ml (range: 3-56), and 2.2. ng/ml (range: 0.3-30.2), respectively. Levels of CA 19-9, CEA, and CA 125 were elevated in 7 (3%), 25 (13%), and 3 (1%) patients, respectively. Median 3-year RFS and OS were 72%. Using the multivariate Cox regression model, elevated levels of CA 19-9 and CEA were found to be independent predictors of worse 3-year OS (hazard ratio [HR] = 2.7, P = 0.05 and HR = 2, P = 0.03, respectively), and an elevated level of CA 19-9 was an independent predictor of worse 3-year RFS (HR = 2.8, P = 0.05). Precystectomy CA 125 level was not associated with oncological outcome. Conclusions: Elevated precystectomy serum levels of CA 19-9 and CEA are independent predictors of worse oncological outcome in patients with invasive UCB. Further studies are needed to elucidate the role of these markers in the management of UCB.
KW - Bladder cancer
KW - Carbohydrate antigen 125
KW - Carbohydrate antigen 19-9
KW - Carcinoembryonic antigen
KW - Prognosis
KW - Serum tumor markers
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UR - http://www.scopus.com/inward/citedby.url?scp=84902551042&partnerID=8YFLogxK
U2 - 10.1016/j.urolonc.2014.01.019
DO - 10.1016/j.urolonc.2014.01.019
M3 - Article
C2 - 24680660
AN - SCOPUS:84902551042
SN - 1078-1439
VL - 32
SP - 648
EP - 656
JO - Urologic Oncology: Seminars and Original Investigations
JF - Urologic Oncology: Seminars and Original Investigations
IS - 5
ER -
