Prognostic Impact of Carcinoembryonic Antigen Levels in Rectal Cancer Patients Who Had Received Neoadjuvant Chemoradiotherapy

Overview

Journal Ann Coloproctol

Date 2021 May 11

PMID 33971705

Citations 4

Authors

Jung Il Joo

Sang Woo Lim

Bo Young Oh

Affiliations

Soon will be listed here.

Abstract

Purpose: Carcinoembryonic antigen (CEA) is a useful marker for rectal cancer. The aim of this study was to investigate the prognostic impact of CEA level according to neoadjuvant chemoradiotherapy (nCRT) in rectal cancer patients who underwent radical surgery.

Methods: A total of 245 patients with rectal cancer who underwent radical surgery were retrospectively evaluated. Serum CEA level was measured preoperatively and postoperatively. We compared survival outcomes based on CEA level before and after surgery according to nCRT.

Results: Of the 245 patients, elevation of CEA level was observed preoperatively in 79 and postoperatively in 30, respectively. Eighty-seven (35.5%) patients received nCRT, and elevated CEA level was a significant prognostic factor both before and after surgery. In patients who had not received nCRT, an elevated CEA level was a significant prognostic factor before surgery but was not significant after surgery. In a multivariate analysis for prognostic factors, elevation of preoperative CEA level was an independent prognostic factor of disease-free survival (DFS) regardless of nCRT. Postoperative CEA level was an independent prognostic factor of DFS in patients who had received nCRT but was not a factor in patients who had not received nCRT.

Conclusion: Serum CEA level was an independent prognostic factor both preoperatively and postoperatively in rectal cancer patients who had received nCRT.

Citing Articles

Unveiling the profound advantages of total neoadjuvant therapy in rectal cancer: a trailblazing exploration.

Jung K, Kim H, Kim H, Lee D, Cheong C Ann Surg Treat Res. 2023; 105(6):341-352.

PMID: 38076602 PMC: 10703582. DOI: 10.4174/astr.2023.105.6.341.

Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II-III Colorectal Cancer.

Park S, Woo H, Hong I, Park E Cancers (Basel). 2023; 15(20).

PMID: 37894465 PMC: 10605496. DOI: 10.3390/cancers15205098.

Prognostic Impact of An Integrative Landscape of Clinical, Immune, and Molecular Features in Non-Metastatic Rectal Cancer.

Iseas S, Sendoya J, Robbio J, Coraglio M, Kujaruk M, Mikolaitis V Front Oncol. 2022; 11:801880.

PMID: 35071006 PMC: 8777220. DOI: 10.3389/fonc.2021.801880.

Carcinoembryonic Antigen, the Most Accessible Test for Predicting Colorectal Cancer Prognosis: Exploring Alternative Roles.

Kang S Ann Coloproctol. 2021; 37(3):129-130.

PMID: 34233114 PMC: 8273716. DOI: 10.3393/ac.2021.00493.0070.

References

Sezgin Goksu S, Goksu U, Gunduz S, Coskun H . Rising CEA levels in a patient with colon carcinoma: metachronous medullary thyroid cancer. Int J Biol Markers. 2014; 29(2):e184-6. DOI: 10.5301/jbm.5000066. View

Ryan J, Warrier S, Lynch A, Ramsay R, Phillips W, Heriot A . Predicting pathological complete response to neoadjuvant chemoradiotherapy in locally advanced rectal cancer: a systematic review. Colorectal Dis. 2015; 18(3):234-46. DOI: 10.1111/codi.13207. View

Chung M, Chung S, Kim J, Ryu M . Prognostic significance of serum carcinoembryonic antigen normalization on survival in rectal cancer treated with preoperative chemoradiation. Cancer Res Treat. 2013; 45(3):186-92. PMC: 3804730. DOI: 10.4143/crt.2013.45.3.186. View

Slentz K, Senagore A, Hibbert J, Mazier W, Talbott T . Can preoperative and postoperative CEA predict survival after colon cancer resection?. Am Surg. 1994; 60(7):528-31; discussion 531-2. View

Molinari C, Matteucci F, Caroli P, Passardi A . Biomarkers and Molecular Imaging as Predictors of Response to Neoadjuvant Chemoradiotherapy in Patients With Locally Advanced Rectal Cancer. Clin Colorectal Cancer. 2015; 14(4):227-38. DOI: 10.1016/j.clcc.2015.05.014. View

Harrison L, Guillem J, Paty P, Cohen A . Preoperative carcinoembryonic antigen predicts outcomes in node-negative colon cancer patients: a multivariate analysis of 572 patients. J Am Coll Surg. 1997; 185(1):55-9. DOI: 10.1016/s1072-7515(97)00012-4. View

Kim N, Hur H . New Perspectives on Predictive Biomarkers of Tumor Response and Their Clinical Application in Preoperative Chemoradiation Therapy for Rectal Cancer. Yonsei Med J. 2015; 56(6):1461-77. PMC: 4630032. DOI: 10.3349/ymj.2015.56.6.1461. View

Duffy M, Lamerz R, Haglund C, Nicolini A, Kalousova M, Holubec L . Tumor markers in colorectal cancer, gastric cancer and gastrointestinal stromal cancers: European group on tumor markers 2014 guidelines update. Int J Cancer. 2013; 134(11):2513-22. PMC: 4217376. DOI: 10.1002/ijc.28384. View

Yang Y, Huang X, Sun J, Gao P, Song Y, Chen X . Prognostic value of perineural invasion in colorectal cancer: a meta-analysis. J Gastrointest Surg. 2015; 19(6):1113-22. DOI: 10.1007/s11605-015-2761-z. View

10.

Bernardes M, Feitosa M, Peria F, Tirapelli D, Rocha J, Feres O . Comparative evaluation of oncologic outcomes in colon cancer. Acta Cir Bras. 2016; 31 Suppl 1:34-9. DOI: 10.1590/S0102-86502016001300008. View

11.

Wanebo H, Rao B, Pinsky C, Hoffman R, Stearns M, Schwartz M . Preoperative carcinoembryonic antigen level as a prognostic indicator in colorectal cancer. N Engl J Med. 1978; 299(9):448-51. DOI: 10.1056/NEJM197808312990904. View

12.

Noura S, Yamamoto H, Ohnishi T, Masuda N, Matsumoto T, Takayama O . Comparative detection of lymph node micrometastases of stage II colorectal cancer by reverse transcriptase polymerase chain reaction and immunohistochemistry. J Clin Oncol. 2002; 20(20):4232-41. DOI: 10.1200/JCO.2002.10.023. View

13.

Jang N, Kang S, Kim D, Kim J, Lee K, Kim I . The role of carcinoembryonic antigen after neoadjuvant chemoradiotherapy in patients with rectal cancer. Dis Colon Rectum. 2011; 54(2):245-52. DOI: 10.1007/DCR.0b013e3181fcee68. View

14.

Ho S, Hyslop A, Albrecht R, Jacobson A, Spencer M, Rothenberger D . Quantification of colorectal cancer micrometastases in lymph nodes by nested and real-time reverse transcriptase-PCR analysis for carcinoembryonic antigen. Clin Cancer Res. 2004; 10(17):5777-84. DOI: 10.1158/1078-0432.CCR-03-0507. View

15.

Locker G, Hamilton S, Harris J, Jessup J, Kemeny N, Macdonald J . ASCO 2006 update of recommendations for the use of tumor markers in gastrointestinal cancer. J Clin Oncol. 2006; 24(33):5313-27. DOI: 10.1200/JCO.2006.08.2644. View

16.

Stiksma J, Grootendorst D, van der Linden P . CA 19-9 as a marker in addition to CEA to monitor colorectal cancer. Clin Colorectal Cancer. 2014; 13(4):239-44. DOI: 10.1016/j.clcc.2014.09.004. View

17.

MOERTEL C, OFallon J, Go V, Oconnell M, Thynne G . The preoperative carcinoembryonic antigen test in the diagnosis, staging, and prognosis of colorectal cancer. Cancer. 1986; 58(3):603-10. DOI: 10.1002/1097-0142(19860801)58:3<603::aid-cncr2820580302>3.0.co;2-k. View

18.

Dienstmann R, Salazar R, Tabernero J . Personalizing colon cancer adjuvant therapy: selecting optimal treatments for individual patients. J Clin Oncol. 2015; 33(16):1787-96. DOI: 10.1200/JCO.2014.60.0213. View

19.

Yang K, Yang S, Liang W, Kuo Y, Lin J, Lin T . Carcinoembryonic antigen (CEA) level, CEA ratio, and treatment outcome of rectal cancer patients receiving pre-operative chemoradiation and surgery. Radiat Oncol. 2013; 8:43. PMC: 3599903. DOI: 10.1186/1748-717X-8-43. View

20.

Kirat H, Ozturk E, Lavery I, Kiran R . The predictive value of preoperative carcinoembryonic antigen level in the prognosis of colon cancer. Am J Surg. 2012; 204(4):447-52. DOI: 10.1016/j.amjsurg.2011.11.007. View