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Table 3 Joint effect of preoperative CEA and CA19-9 on colorectal cancer outcomes

From: Preoperative serum CA19-9 should be routinely measured in the colorectal patients with preoperative normal serum CEA: a multicenter retrospective cohort study

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
  1. Note: CA 19–9 carbohydrate antigen 19–9, CEA carcinoembryonic antigen, OS overall survival, RFS recurrence-free survival
  2. Elevated CEA ≥ 5 ng/ml, normal CEA < 5 ng/ml; elevated CA 19–9 ≥ 37 U/ml, normal CA 19–9 < 37 U/ml
  3. 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)