Significance of CEA and CA19-9 combination as a prognostic indicator and for recurrence monitoring in patients with stage II colorectal cancer.

BACKGROUND The purpose of this study was to evaluate the significance of the combination of the carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels as a prognostic indicator and for monitoring for recurrence and metastasis after potentially curative surgery for patients with stage II colorectal cancer. PATIENTS AND METHODS A total of 238 patients with stage II colorectal cancer who underwent potentially curative surgery were enrolled in the study. A high CEA level was defined as a level exceeding 5 ng/ml and a high CA19-9 level was defined as a level exceeding 37 U/ml. RESULTS Out of these 238 patients, 92 (38.7%) patients had high CEA levels, 23 (9.7%) patients had high CA19-9 levels and 15 (6.3%) patients had both high CEA and CA19-9 levels. The disease-free and overall survival rates were significantly worse in patients with both a high CEA level and high CA19-9 level. Tumor marker(s) elevated before the operation tended to be elevated again at the time of relapse. CONCLUSION The combination of preoperative CEA and CA19-9 levels was useful for predicting the prognosis and for monitoring recurrence and metastasis after potentially curative surgery in patents with stage II colorectal cancer.