{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T14:06:10Z","timestamp":1779545170965,"version":"3.53.1"},"reference-count":39,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,5,23]],"date-time":"2026-05-23T00:00:00Z","timestamp":1779494400000},"content-version":"vor","delay-in-days":11,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Japanese Society for Cancer of the Colon and Rectum"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Currently, no international guidelines recommend carbohydrate antigen 19-9 (CA19-9) as a biomarker in colorectal cancer in clinical practice, although it has been reported that tumour cells with high affinity for peritoneal cells strongly express CA19-9. The aim of this study was to determine the utility of preoperative serum CA19-9 levels in predicting prognosis in patients with colorectal cancer and synchronous peritoneal metastasis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Prognostic analyses were retrospectively performed in patients with colorectal cancer and synchronous peritoneal metastases who received treatment in 16 hospitals between 1991 and 2007 (Cohort 1). The categorization for CA19-9 and carcinoembryonic antigen were established based on the thresholds that minimized Akaike information criterion values for overall survival. A separate validation cohort of patients with synchronous peritoneal metastasis was prospectively registered across 28 institutions between 2012 and 2016 (Cohort 2) to validate these findings.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 689 patients were analysed in Cohort 1 and 144 in the validation Cohort 2. The categorized serum CA19-9 and carcinoembryonic antigen levels were significantly correlated with overall survival (P &amp;lt; 0.001 and P &amp;lt; 0.001, respectively). The median postoperative overall survival was 19.0 months for patients with a preoperative CA19-9 level &amp;lt; 100\u2005U\/ml compared with 4.1 months for those with a preoperative CA19-9 level of \u2265 10 000\u2005U\/ml. Using multivariable analysis, serum CA19-9, but not carcinoembryonic antigen, was an independent prognostic factor for overall survival. These results were confirmed in Cohort 2, revealing that the prognostic power of CA19-9 was superior to that of carcinoembryonic antigen.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Preoperative serum CA19-9 outperformed carcinoembryonic antigen as an independent prognostic biomarker in patients with colorectal cancer and peritoneal metastasis.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjsopen\/zrag060","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T11:41:20Z","timestamp":1776339680000},"source":"Crossref","is-referenced-by-count":0,"title":["Preoperative carbohydrate antigen 19-9 as a prognostic biomarker in colorectal cancer with synchronous peritoneal metastasis: multicentre cohort study"],"prefix":"10.1093","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4158-2564","authenticated-orcid":false,"given":"Keita","family":"Tashiro","sequence":"first","affiliation":[{"name":"Department of Surgery, National Defence Medical College Hospital , Saitama ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoshiki","family":"Kajiwara","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Defence Medical College Hospital , Saitama ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8600-1199","authenticated-orcid":false,"given":"Hideki","family":"Ueno","sequence":"additional","affiliation":[{"name":"Department of Surgery, National Defence Medical College Hospital , Saitama ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hirotoshi","family":"Kobayashi","sequence":"additional","affiliation":[{"name":"Department of Surgery, Teikyo University Mizonokuchi Hospital , Kanagawa ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenjiro","family":"Kotake","sequence":"additional","affiliation":[{"name":"Department of Gastroenterology and Surgery, Sano City Hospital , Tochigi ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kenichi","family":"Sugihara","sequence":"additional","affiliation":[{"name":"Institute of Science Tokyo , Tokyo ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yoichi","family":"Ajioka","sequence":"additional","affiliation":[{"name":"Department of Division of Molecular and Diagnostic Pathology, Niigata University , Niigata ,","place":["Japan"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,5,23]]},"reference":[{"key":"2026052309291533800_zrag060-B1","doi-asserted-by":"crossref","first-page":"1709","DOI":"10.1016\/S1470-2045(16)30500-9","article-title":"Prognosis of patients with peritoneal metastatic colorectal cancer given systemic therapy: an analysis of individual patient data from prospective randomised trials from the analysis and research in cancers of the digestive system (ARCAD) database","volume":"17","author":"Franko","year":"2016","journal-title":"Lancet Oncol"},{"key":"2026052309291533800_zrag060-B2","volume-title":"TNM classification of Malignant Tumours","author":"International Union Against Cancer (UICC)","year":"2017","edition":"8th edn"},{"key":"2026052309291533800_zrag060-B3","volume-title":"American Joint Committee on Cancer (AJCC) Cancer Staging Manual","year":"2017","edition":"8th edn"},{"key":"2026052309291533800_zrag060-B4","volume-title":"Japanese Classification of Colorectal, Appendiceal, and Anal Carcinoma","author":"Japanese Society for Cancer of the Colon and Rectum","year":"2019","edition":"3rd English edn"},{"key":"2026052309291533800_zrag060-B5","doi-asserted-by":"crossref","first-page":"327","DOI":"10.1245\/s10434-008-0234-2","article-title":"Evaluation of preoperative computed tomography in estimating peritoneal cancer index in colorectal peritoneal carcinomatosis","volume":"16","author":"Koh","year":"2009","journal-title":"Ann Surg Oncol"},{"key":"2026052309291533800_zrag060-B6","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1007\/s00261-007-9211-7","article-title":"Staging of peritoneal carcinomatosis; 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