دورية أكاديمية
أعرض في EDS

Serum Tumor Markers and Outcomes in Patients With Appendiceal Adenocarcinoma.

التفاصيل البيبلوغرافية
العنوان: Serum Tumor Markers and Outcomes in Patients With Appendiceal Adenocarcinoma.
المؤلفون: Yousef A; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Yousef M; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Zeineddine MA; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., More A; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Fanaeian M; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Chowdhury S; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Knafl M; Department of Genomic Medicine, University of Texas MD Anderson Cancer Center, Houston., Edelkamp P; Department of Data Engineering and Analytics, University of Texas MD Anderson Cancer Center, Houston., Ito I; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Gu Y; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Pattalachinti V; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Naini ZA; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Zeineddine FA; Department of Internal Medicine, Houston Methodist Hospital, Houston, Texas., Peterson J; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Alfaro K; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Foo WC; Department of Pathology, University of Texas MD Anderson Cancer Center, Houston., Jin J; Department of Enterprise Development and Integration, University of Texas MD Anderson Cancer Center, Houston., Bhutiani N; Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center, Houston., Higbie V; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Scally CP; Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston., Kee B; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Kopetz S; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Goldstein D; Palantir Technologies, Denver, Colorado., Strach M; Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Manchester, United Kingdom.; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Manchester, United Kingdom.; Faculty of Medicine and Health, The University of Sydney, Darlington, Victoria, Australia., Williamson A; Department of Medical Oncology, The Christie National Health Service Foundation Trust, Manchester, United Kingdom., Aziz O; Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Manchester, United Kingdom.; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Manchester, United Kingdom., Barriuso J; Colorectal and Peritoneal Oncology Centre, The Christie NHS Foundation Trust, Manchester, United Kingdom.; Division of Cancer Sciences, Faculty of Biology, Medicine and Health, School of Medical Sciences, University of Manchester, Manchester, United Kingdom., Uppal A; Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center, Houston., White MG; Department of Colon and Rectal Surgery, University of Texas MD Anderson Cancer Center, Houston., Helmink B; Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston., Fournier KF; Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, Houston., Raghav KP; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Taggart MW; Department of Pathology, University of Texas MD Anderson Cancer Center, Houston., Overman MJ; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston., Shen JP; Department of Gastrointestinal Medical Oncology, University of Texas MD Anderson Cancer Center, Houston.
المصدر: JAMA network open [JAMA Netw Open] 2024 Feb 05; Vol. 7 (2), pp. e240260. Date of Electronic Publication: 2024 Feb 05.
نوع المنشور: Journal Article
اللغة: English
بيانات الدورية: Publisher: American Medical Association Country of Publication: United States NLM ID: 101729235 Publication Model: Electronic Cited Medium: Internet ISSN: 2574-3805 (Electronic) Linking ISSN: 25743805 NLM ISO Abbreviation: JAMA Netw Open Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Chicago, IL : American Medical Association, [2018]-
مواضيع طبية MeSH: Adenocarcinoma*/diagnosis , Appendiceal Neoplasms* , Neoplasms, Second Primary*, Humans ; Middle Aged ; Aged ; Aged, 80 and over ; Biomarkers, Tumor ; Retrospective Studies ; CA-19-9 Antigen ; Carcinoembryonic Antigen ; CA-125 Antigen
مستخلص: Importance: Serum tumor markers carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA19-9), and cancer antigen 125 (CA125) have been useful in the management of gastrointestinal and gynecological cancers; however, there is limited information regarding their utility in patients with appendiceal adenocarcinoma.
Objective: To assess the association of serum tumor markers (CEA, CA19-9, and CA125) with clinical outcomes and pathologic and molecular features in patients with appendiceal adenocarcinoma.
Design, Setting, and Participants: This is a retrospective cohort study at a single tertiary care comprehensive cancer center. The median (IQR) follow-up time was 52 (21-101) months. Software was used to query the MD Anderson internal patient database to identify patients with a diagnosis of appendiceal adenocarcinoma and at least 1 tumor marker measured at MD Anderson between March 2016 and May 2023. Data were analyzed from January to December 2023.
Main Outcomes and Measures: Association of serum tumor markers with survival in patients with appendiceal adenocarcinoma. Cox proportional hazards regression analyses were also performed to assess associations between clinical factors (serum tumor marker levels, demographics, and patient and disease characteristics) and patient outcomes (overall survival).
Results: A total of 1338 patients with appendiceal adenocarcinoma were included, with a median (range) age at diagnosis of 56.5 (22.3-89.6) years. The majority of the patients had metastatic disease (1080 patients [80.7%]). CEA was elevated in 742 of the patients tested (56%), while CA19-9 and CA125 were elevated in 381 patients (34%) and 312 patients (27%), respectively. Individually, elevation of CEA, CA19-9, or CA125 were associated with worse 5-year survival; elevated vs normal was 81% vs 95% for CEA (hazard ratio [HR], 4.0; 95% CI, 2.9-5.6), 84% vs 92% for CA19-9 (HR, 2.2; 95% CI, 1.4-3.4), and 69% vs 93% for CA125 (HR, 4.6; 95% CI, 2.7-7.8) (P < .001 for all). Quantitative evaluation of tumor markers was associated with outcomes. Patients with highly elevated (top 10th percentile) CEA, CA19-9, or CA125 had markedly worse survival, with 5-year survival rates of 59% for CEA (HR, 9.8; 95% CI, 5.3-18.0), 64% for CA19-9 (HR, 6.0; 95% CI, 3.0-11.7), and 57% for CA125 (HR, 7.6; 95% CI, 3.5-16.5) (P < .001 for all). Although metastatic tumors had higher levels of all tumor markers, when restricting survival analysis to 1080 patients with metastatic disease, elevated CEA, CA19-9, or CA125 were all still associated worse survival (HR for CEA, 3.4; 95% CI, 2.5-4.8; P < .001; HR for CA19-9, 1.8; 95% CI, 1.2-2.7; P = .002; and HR for CA125, 3.9; 95% CI, 2.4-6.4; P < .001). Interestingly, tumor grade was not associated with CEA or CA19-9 level, while CA-125 was slightly higher in high-grade tumors relative to low-grade tumors (mean value, 18.3 vs 15.0; difference, 3.3; 95% CI, 0.9-3.7; P < .001). Multivariable analysis identified an incremental increase in the risk of death with an increase in the number of elevated tumor markers, with an 11-fold increased risk of death in patients with all 3 tumor markers elevated relative to those with none elevated. Somatic mutations in KRAS and GNAS were associated with significantly higher levels of CEA and CA19-9.
Conclusions and Relevance: In this retrospective study of serum tumor markers in patients with appendiceal adenocarcinoma, CEA, CA19-9, and CA125 were associated with overall survival in appendiceal adenocarcinoma. Given their value, all 3 biomarkers should be included in the initial workup of patients with a diagnosis of appendiceal adenocarcinoma.
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المشرفين على المادة: 0 (Biomarkers, Tumor)
0 (CA-19-9 Antigen)
0 (Carcinoembryonic Antigen)
0 (CA-125 Antigen)
تواريخ الأحداث: Date Created: 20240228 Date Completed: 20240229 Latest Revision: 20240302
رمز التحديث: 20240302
مُعرف محوري في PubMed: PMC10902735
DOI: 10.1001/jamanetworkopen.2024.0260
PMID: 38416491
قاعدة البيانات: MEDLINE
الوصف
تدمد:2574-3805
DOI:10.1001/jamanetworkopen.2024.0260