Abstract
Context
Introduction
Bladder cancer (BC) is the 11th most common cancer in the general
population of Europe, with the worldwide age-standardized mortality
rate (per 100.000 persons/year) is estimated at 3.2 for men and 0.9
for women, respectively. Over the years, a distant effort by researchers
has been made to provide new prognostic biomarkers in the assessment of
accurate response to treatment and prompt detection of
recurrences. Among several markers, the carbohydrate-rich glycoprotein,
Carbohydrate Antigen (CA) 19-9 has shown some usefulness as it
is linked with the tumour aggressiveness and the prognosis of the disease.
Objective
To perform a systematic review, and describe current evidence and
perspectives about the role of carbohydrate antigen 19-9 in diagnosing,
staging and prognosis of bladder cancer.
Evidence acquisition
We searched PubMed, Embase and Cochrane Library, irrespective of
dateline for a systemic review of evaluation of carbohydrate antigen 19-9
use in the management of bladder cancer.
Evidence synthesis
A total of 16 useful and valued studies were found on the database. These
studies evaluated relation of Carbohydrate Antigen 19-9 to various
different aspects of bladder cancer. These aspects include use of
Carbohydrate antigen 19-9 as a tool for detection of bladder cancer, its
role in the assessment of the prognosis at diagnosis and also looked at the
significance of the CA 19-9 in the response to treatment of bladder
cancer.

Conclusions
Results from studies are encouraging, but due to the limited evidence,
there can be no strong recommendation for the usage of
the biomarker CA 19-9 as a tool in the diagnosis and follow-up of non-
muscle invasive bladder cancer. On the other hand, it seems that in cases
of invasive disease and advanced or metastatic urothelial carcinoma,
this biomarker could be a useful part in the assessment of the possible
progression, future recurrence and overall survival of patients with
this condition. Further cohorts are necessary in order that the exact role, if
any, of this biomarker to be clarified.

Use of Carbohydrate Antigen 19-9 in the management of bladder cancer