Trajectories of Perioperative Serum Tumor Markers and Colorectal Cancer Outcomes: A Retrospective, Multicenter Longitudinal Cohort Study

Background: The dynamic monitoring of perioperative carcinoembryonic antigen (CEA) is recommended by current colorectal cancer (CRC) guidelines, while the benefits of additional measurements of carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125) have remained controversial. Metho...

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Autores principales:	Chunxia Li, Dafu Zhang, Xiaolin Pang, Hongjiang Pu, Ming Lei, Bingbing Fan, Jiali Lv, Dingyun You, Zhenhui Li, Tao Zhang
Formato:	article
Lenguaje:	EN
Publicado:	Elsevier 2021
Materias:	Colorectal cancer Serum tumor markers Trajectories Overall survival Recurrence-free survival Medicine R Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/3747605cd890484bb4553b7e6fa412ed
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spelling	oai:doaj.org-article:3747605cd890484bb4553b7e6fa412ed2021-11-20T05:06:59ZTrajectories of Perioperative Serum Tumor Markers and Colorectal Cancer Outcomes: A Retrospective, Multicenter Longitudinal Cohort Study2352-396410.1016/j.ebiom.2021.103706https://doaj.org/article/3747605cd890484bb4553b7e6fa412ed2021-12-01T00:00:00Zhttp://www.sciencedirect.com/science/article/pii/S2352396421005004https://doaj.org/toc/2352-3964Background: The dynamic monitoring of perioperative carcinoembryonic antigen (CEA) is recommended by current colorectal cancer (CRC) guidelines, while the benefits of additional measurements of carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125) have remained controversial. Methods: This retrospective longitudinal cohort included 3539 CRC patients who underwent curative resection. Distinct trajectory groups were identified by the latent class growth mixed model. Patients were grouped into subgroups jointly by CEA, CA19-9, and CA125 according to preoperative levels and longitudinal trajectories, respectively. The end points were overall survival (OS) and recurrence-free survival (RFS). Findings: Three distinct trajectory groups were characterized for serum CEA, CA19-9, and CA125: low-stable, early-rising, and later-rising. Jointly, patients were grouped into six preoperative (trajectory) joint groups. Compared with the three-low group, the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) associated with death were 1.87 (1.29-2.70), 3.82 (2.37-6.17), 1.87 (0.97-3.61), 2.81 (1.93-4.11), and 4.99 (2.80-8.86) for the CEA-high, CA19-9-high, CA125-high, two-high, and three-high group, respectively. And compared with the three-stable trajectory group, the corresponding HRs (95% CIs) were 1.59 (1.10-2.30), 1.55 (0.77-3.10), 6.25 (4.02-9.70), 4.05 (2.73-6.02), and 12.40 (5.77-26.70) for the five rising trajectory groups, respectively. Similar associations between joint groups and RFS were observed. Notably, the trajectory joint group still had prognostic significance after adjusting for preoperative levels. The CA19-9-high group (HR: 3.82, 95% CI: 2.37-6.17) was associated with higher risk of death than the two-high group (HR: 2.81, 95% CI: 1.93-4.11). Likewise, for the CA125-rising trajectory group and two-rising trajectory group, the HRs (95% CIs) were 6.13 (3.75-10.00) and 3.99 (2.63-6.05) for death, and 3.08 (2.07-4.58) and 2.10 (1.52-2.90) for recurrence. Interpretation: In addition to CEA, the dynamic measurements of CA19-9 and CA125 are recommended to monitor the prognosis of CRC patients. Funding: National Natural Science Foundation of China [81973147, 82001986, 81960592, 82073569, 81660545].Chunxia LiDafu ZhangXiaolin PangHongjiang PuMing LeiBingbing FanJiali LvDingyun YouZhenhui LiTao ZhangElsevierarticleColorectal cancerSerum tumor markersTrajectoriesOverall survivalRecurrence-free survivalMedicineRMedicine (General)R5-920ENEBioMedicine, Vol 74, Iss , Pp 103706- (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Colorectal cancer Serum tumor markers Trajectories Overall survival Recurrence-free survival Medicine R Medicine (General) R5-920
spellingShingle	Colorectal cancer Serum tumor markers Trajectories Overall survival Recurrence-free survival Medicine R Medicine (General) R5-920 Chunxia Li Dafu Zhang Xiaolin Pang Hongjiang Pu Ming Lei Bingbing Fan Jiali Lv Dingyun You Zhenhui Li Tao Zhang Trajectories of Perioperative Serum Tumor Markers and Colorectal Cancer Outcomes: A Retrospective, Multicenter Longitudinal Cohort Study
description	Background: The dynamic monitoring of perioperative carcinoembryonic antigen (CEA) is recommended by current colorectal cancer (CRC) guidelines, while the benefits of additional measurements of carbohydrate antigen 19-9 (CA19-9) and carbohydrate antigen 125 (CA125) have remained controversial. Methods: This retrospective longitudinal cohort included 3539 CRC patients who underwent curative resection. Distinct trajectory groups were identified by the latent class growth mixed model. Patients were grouped into subgroups jointly by CEA, CA19-9, and CA125 according to preoperative levels and longitudinal trajectories, respectively. The end points were overall survival (OS) and recurrence-free survival (RFS). Findings: Three distinct trajectory groups were characterized for serum CEA, CA19-9, and CA125: low-stable, early-rising, and later-rising. Jointly, patients were grouped into six preoperative (trajectory) joint groups. Compared with the three-low group, the adjusted hazard ratios (HRs) and 95% confidence intervals (CIs) associated with death were 1.87 (1.29-2.70), 3.82 (2.37-6.17), 1.87 (0.97-3.61), 2.81 (1.93-4.11), and 4.99 (2.80-8.86) for the CEA-high, CA19-9-high, CA125-high, two-high, and three-high group, respectively. And compared with the three-stable trajectory group, the corresponding HRs (95% CIs) were 1.59 (1.10-2.30), 1.55 (0.77-3.10), 6.25 (4.02-9.70), 4.05 (2.73-6.02), and 12.40 (5.77-26.70) for the five rising trajectory groups, respectively. Similar associations between joint groups and RFS were observed. Notably, the trajectory joint group still had prognostic significance after adjusting for preoperative levels. The CA19-9-high group (HR: 3.82, 95% CI: 2.37-6.17) was associated with higher risk of death than the two-high group (HR: 2.81, 95% CI: 1.93-4.11). Likewise, for the CA125-rising trajectory group and two-rising trajectory group, the HRs (95% CIs) were 6.13 (3.75-10.00) and 3.99 (2.63-6.05) for death, and 3.08 (2.07-4.58) and 2.10 (1.52-2.90) for recurrence. Interpretation: In addition to CEA, the dynamic measurements of CA19-9 and CA125 are recommended to monitor the prognosis of CRC patients. Funding: National Natural Science Foundation of China [81973147, 82001986, 81960592, 82073569, 81660545].
format	article
author	Chunxia Li Dafu Zhang Xiaolin Pang Hongjiang Pu Ming Lei Bingbing Fan Jiali Lv Dingyun You Zhenhui Li Tao Zhang
author_facet	Chunxia Li Dafu Zhang Xiaolin Pang Hongjiang Pu Ming Lei Bingbing Fan Jiali Lv Dingyun You Zhenhui Li Tao Zhang
author_sort	Chunxia Li
title	Trajectories of Perioperative Serum Tumor Markers and Colorectal Cancer Outcomes: A Retrospective, Multicenter Longitudinal Cohort Study
title_short	Trajectories of Perioperative Serum Tumor Markers and Colorectal Cancer Outcomes: A Retrospective, Multicenter Longitudinal Cohort Study
title_full	Trajectories of Perioperative Serum Tumor Markers and Colorectal Cancer Outcomes: A Retrospective, Multicenter Longitudinal Cohort Study
title_fullStr	Trajectories of Perioperative Serum Tumor Markers and Colorectal Cancer Outcomes: A Retrospective, Multicenter Longitudinal Cohort Study
title_full_unstemmed	Trajectories of Perioperative Serum Tumor Markers and Colorectal Cancer Outcomes: A Retrospective, Multicenter Longitudinal Cohort Study
title_sort	trajectories of perioperative serum tumor markers and colorectal cancer outcomes: a retrospective, multicenter longitudinal cohort study
publisher	Elsevier
publishDate	2021
url	https://doaj.org/article/3747605cd890484bb4553b7e6fa412ed
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Trajectories of Perioperative Serum Tumor Markers and Colorectal Cancer Outcomes: A Retrospective, Multicenter Longitudinal Cohort Study

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