Impact of preoperative serum carbohydrate antigen 19-9 levels on prognosis of hepatocellular carcinoma patients after partial hepatectomy / 中华肝胆外科杂志

ABSTRACT

Objective:To study the relationship between preoperative serum carbohydrate antigen 19-9 (CA19-9) levels and long-term prognosis after partial hepatectomy in patients with hepatocellular carcinoma (HCC).Methods:The clinical data of 1102 patients with HCC who underwent partial hepatectomy at the Affiliated Tumor Hospital of Guangxi Medical University from January 2012 to December 2017 were retrospectively analyzed. There were 960 males and 142 females, with an average age of 51 years. The X-tile software determined the best cut-off value of CA19-9 to be 55U/ml. The enrolled patients were then divided into the low-level (CA19-9≤55 U/ml, n=956) and high-level (CA19-9 >55 U/ml, n=146) groups. The Kaplan-Meier method was used to analyze survival, and the log-rank test was performed to evaluate survival rates. The prognostic risk factors of HCC were calculated by the Cox proportional hazards model. Results:The 1, 3, and 5-year survival rates for the low-level group were 85.0%, 68.2%, and 60.9%, respectively, which were significantly higher than those of the high-level group of 80.1%, 58.2%, and 47.0%, respectively ( P<0.05) . The 1, 3, and 5-year recurrence-free survival rates of the low level group were 60.5%, 44.6%, and 37.9% respectively, which were significantly higher than those in the high-level group of 53.4%, 33.3%, and 25.1%, respectively ( P<0.05). Cox regression analysis showed that patients with CA19-9 >55 U/ml ( HR=1.323, 95% CI 1.070-1.636, P=0.010) had a higher risk of recurrence after hepatectomy, while patients with CA19-9 >55 U/ml ( HR=1.511, 95% CI 1.163-1.964, P=0.002) had a poor prognosis after hepatectomy. Conclusions:Preoperative serum level of CA19-9>55 U/ml was an independent risk factor for survival and recurrence of HCC patients after partial hepatectomy. CA19-9 had a significant predictive value for prognosis of HCC patients who underwent partial hepatectomy.