Assessment of the value of carcinoembryonic antigen reduction ratio as a prognosis factor in rectal cancer

Am J Surg. 2014 Jul;208(1):99-105. doi: 10.1016/j.amjsurg.2013.08.054. Epub 2014 Jan 16.

Abstract

Background: Carcinoembryonic antigen (CEA) is the most widely used tumor marker for colorectal cancer. This study aimed to investigate the role of CEA reduction ratio after preoperative chemoradiotherapy (CRT).

Methods: We enrolled 284 patients who underwent preoperative CRT followed by radical surgical resection. Patients were divided into 3 groups: serum CEA levels before CRT (pre-CRT CEA) less than 5 ng/mL (group 1); pre-CRT CEA of 5 ng/mL or more with CEA reduction ratio of 50% or more (group 2); and pre-CRT CEA of 5 ng/mL or more with CEA reduction ratio less than 50% (group 3).

Results: The 5-year disease-free survival (DFS) rate was not different between groups 1 (71.8%) and 2 (69.4%) but was significantly lower in group 3 (49.5%). CEA group, lymph node status after CRT (ypN) stage, and histologic type were independent prognostic factors for DFS on multivariate analysis.

Conclusions: CEA reduction ratio might be an independent prognostic factor for DFS in rectal cancer patients treated with preoperative CRT and radical surgery.

Keywords: CEA reduction ratio; Carcinoembryonic antigen; Preoperative chemoradiotherapy; Rectal cancer.

Publication types

  • Evaluation Study

MeSH terms

  • Adenocarcinoma / blood
  • Adenocarcinoma / therapy*
  • Adult
  • Aged
  • Aged, 80 and over
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Carcinoembryonic Antigen / blood*
  • Chemoradiotherapy, Adjuvant*
  • Disease-Free Survival
  • Dose Fractionation, Radiation
  • Female
  • Follow-Up Studies
  • Humans
  • Leucovorin / administration & dosage
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Prognosis
  • Rectal Neoplasms / blood
  • Rectal Neoplasms / therapy*
  • Rectum / surgery
  • Retrospective Studies
  • Tegafur / administration & dosage
  • Treatment Outcome
  • Uracil / administration & dosage

Substances

  • Carcinoembryonic Antigen
  • Tegafur
  • Uracil
  • Leucovorin