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Tumor Marker Index Based on CEA and CA19-9 as a Prognostic Biomarker in Resectable Colon Cancer
Tatsufumi Kosuge1, Junichi Mazaki1, Kenta Kasahara1
1Department of Gastrointestinal and Pediatric Surgery, Tokyo Medical University, Tokyo, Japan.
Cancer Diagnosis & Prognosis
|July 2, 2026
Summary
The tumor marker index (TMI), calculated from carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) levels, can predict recurrence after colon cancer surgery. A lower TMI is associated with better recurrence-free survival, aiding in risk stratification.
Area of Science:
- Oncology
- Biomarkers
- Cancer Prognostics
Background:
- Prognosis for colon cancer post-curative resection varies, necessitating biomarkers beyond TNM staging.
- Tumor markers show promise in predicting outcomes, similar to their role in pancreatic cancer.
Purpose of the Study:
- To investigate the prognostic significance of a novel Tumor Marker Index (TMI) in curatively resected colon cancer.
- To evaluate TMI's ability to complement TNM staging for improved risk stratification.
Main Methods:
- Retrospective review of 361 colon cancer patients undergoing curative resection (2011-2023).
- TMI calculated as the product of preoperative serum CEA and CA19-9 levels.
- Patients stratified into low- and high-TMI groups; 3-year recurrence-free survival (3y-RFS), local recurrence-free survival (3y-LRFS), and distant metastasis-free survival (3y-DMFS) compared.
Main Results:
- Optimal TMI cutoff determined as 64; 226 patients in low-TMI, 135 in high-TMI group.
- Low-TMI group showed significantly higher 3y-RFS (94.0% vs. 88.4%, p=0.023) and 3y-LRFS (97.7% vs. 95.2%, p=0.044).
- No significant difference in 3y-DMFS between groups (95.4% vs. 91.4%, p=0.103).
Conclusions:
- TMI is associated with postoperative recurrence patterns in curatively resected colon cancer.
- TMI may serve as a valuable biomarker for risk stratification post-surgery.
- This index can potentially enhance TNM staging for better patient management.
