THE PROGNOSTIC VALUE OF CEA AND CA 19-9 IN DETERMINING SURVIVAL OUTCOMES FOR PATIENT WITH LOW RECTAL CANCER

The prognostic value of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA 19-9) is a topic of interest for surgeons. The aim of this retrospective study was to evaluate the prognostic value of CEA and CA 19-9 in patients with locally advanced low rectal cancer who underwent neoadjuvant chemoradiotherapy, underlining their potential as indicators for survival outcomes. . Materials and methods: Between November 2019 and February 2023, we evaluated the medical records of 104 patients admitted to the first Oncologic Surgical Clinic from the Regional Institute of Oncology, Iasi, Romania. Clinical and paraclinical data was recorded, and patients were segregated intro three groups: one marker elevated during follow-up (group 1), 2 markers elevated during follow-up (group 2), and no marker elevated during follow-up (group 3). The overall survival and recurrence-free survival were the evaluated outcomes, and the prognostic values of serum markers were evaluated using Cox regression model and Kaplan-Meyer survival analysis. (3) Results: The presence of one (hazard ratio, HR: 2.78, 95% confidence interval, CI: 1.11- 6.92, p = 0.02) or both (HR: 4.23, 95%CI: 1.449.32, p =0.03) elevated markers statistically decreased the recurrence-free survival time. A combination of elevated markers has a significantly higher impact on the recurrence-free survival time compared to a single elevated marker (p=0.001). p =0.001). Only the combination of biomarkers significantly decreased the overall survival rates (HR: 3.74, 95% CI: 0.57- 7.62, p = 0.04). (4) Conclusions: The combination of elevated CEA and CA 19-9 had the highest prognostic significance for the evaluated survival outcomes.