Nonetheless, our study showed a relevant association between mPM and elevated preoperative CEA and CA 19-9, preoperative obstruction, advanced tumor stage represented by both serosal invasion (pT4) and lymph node metastases, infiltration of circumferential resection margins, poor differentiation, lymphovascular invasion, and perineural invasion. This evidence concerns the gene CEACAM5 and metastatic malignant neoplasm in the lymph nodes.