Preoperative CA 19-9 predicts disease progression after CRS-HIPEC for colorectal peritoneal metastasis: retrospective analysis

Patients with peritoneal metastases from colorectal cancer (CRPM) are increasing treated withcytoreductive surgery and hyperthermic intraperitoneal chemotherapy (CRS-HIPEC). Data identifying preoperative risk factors for poor oncologic outcomes after this procedure are limited. A retrospective analysis by the US HIPEC Collaborative found that preoperative elevated CA 19-9, but not CEA or CA 125, was associated with decreased progression-free survival. In the subgroup of patients who underwent upfront CRS-HIPEC, CA 19-9 was the sole tumor marker independently predictive of worse PFS (HR 2.88; p=0.048). In the subgroup of patients who had received neoadjuvant therapy, no preoperative variable was independently predictive of PFS. The authors conclude that while traditionally CEA is the main tumor marker in colon cancer, this analysis found that CA 19-9 may better inform preoperative risk stratification for poor oncologic outcomes after CRS-HIPEC for CRPM. Prospective studies are required to confirm this association.