Table 3.
Joint effect of preoperative CEA and CA19-9 on colorectal cancer outcomes
| Outcome | Model 1 | Model 2 | Model 3 | Model 4 | ||||
|---|---|---|---|---|---|---|---|---|
|
Hazard Ratio (95% CI) |
P Value | Hazard Ratio (95% CI) | P Value | Hazard Ratio (95% CI) | P Value | Hazard Ratio (95% CI) | P Value | |
| RFS | ||||||||
| Normal CEA & normal CA19-9 | Reference | Reference | Reference | Reference | ||||
| Normal CEA & elevated CA19-9 | 2.32 (1.87–2.88) | < 0.001 | 2.38 (1.92–2.96) | < 0.001 | 2.08 (1.65–2.62) | < 0.001 | 2.00 (1.46–2.72) | < 0.001 |
| Elevated CEA & normal CA19-9 | 1.54 (1.37–1.73) | < 0.001 | 1.52 (1.35–1.71) | < 0.001 | 1.50 (1.32–1.70) | < 0.001 | 1.65 (1.40–1.95) | < 0.001 |
| Elevated CEA & elevated CA19-9 | 2.41 (2.08–2.8) | < 0.001 | 2.38 (2.05–2.76) | < 0.001 | 2.31 (1.97–2.71) | < 0.001 | 2.76 (2.24–3.39) | < 0.001 |
| OS | ||||||||
| Normal CEA & normal CA19-9 | Reference | Reference | Reference | Reference | ||||
| Normal CEA & elevated CA19-9 | 2.85 (2.18–3.72) | < 0.001 | 3.02 (2.31–3.94) | < 0.001 | 2.52 (1.88–3.37) | < 0.001 | 2.20 (1.46–3.32) | < 0.001 |
| Elevated CEA & normal CA19-9 | 1.76 (1.51–2.05) | < 0.001 | 1.70 (1.46–1.98) | < 0.001 | 1.70 (1.45–2.01) | < 0.001 | 1.90 (1.52–2.38) | < 0.001 |
| Elevated CEA & elevated CA19-9 | 2.89 (2.40–3.48) | < 0.001 | 2.75 (2.28–3.32) | < 0.001 | 2.62 (2.14–3.21) | < 0.001 | 3.23 (2.46–4.24) | < 0.001 |
Note: CA 19–9 carbohydrate antigen 19–9, CEA carcinoembryonic antigen, OS overall survival, RFS recurrence-free survival
Elevated CEA ≥ 5 ng/ml, normal CEA < 5 ng/ml; elevated CA 19–9 ≥ 37 U/ml, normal CA 19–9 < 37 U/ml
Model 1 was unadjusted. Model 2 was adjusted for sex (female vs. male), age. Model 3 was adjusted for sex (female vs. male), age, primary site (rectum vs. colon), surgical approach (open resection vs. laparoscopic resection), pathology stage (III → II), lymph node yield (≥ 12 vs. < 12), tumor differentiation (poor-undifferentiated vs. moderate vs. well), mucinous (colloid) type (yes vs. no), lymphovascular invasion / perineural invasion (yes vs. no), adjuvant chemotherapy (yes vs. no). Model 4 was adjusted for sex (female vs. male), age, primary site (rectum vs. colon), surgical approach (open resection vs. laparoscopic resection), pathology stage (III → II), lymph node yield (≥ 12 vs. < 12), tumor differentiation (poor-undifferentiated vs. moderate vs. well), mucinous (colloid) type (yes vs. no), lymphovascular invasion / perineural invasion (yes vs. no), adjuvant chemotherapy (yes vs. no), microsatellite instability (yes vs. no)