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

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

Author information

1
Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan.
2
School of Medicine, National Yang-Ming University, Taiwan; Cancer Center, Taipei Veterans General Hospital, Taiwan.
3
School of Medicine, National Yang-Ming University, Taiwan; Department of Pathology, Taipei Veterans General Hospital, Taiwan.
4
Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan. Electronic address: changsc@vghtpe.gov.tw.

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

PMID:
24524862
DOI:
10.1016/j.amjsurg.2013.08.054
[Indexed for MEDLINE]
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