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

• Published in: The American journal of surgery Vol. 208; no. 1; pp. 99 - 105
• Main Authors: Huang, Chih-Sheng, M.D, Lin, Jen-Kou, M.D., Ph.D, Wang, Ling-Wei, M.D, Liang, Wen-Yih, M.D, Lin, Chun-Chi, M.D, Lan, Yuan-Tzu, M.D., Ph.D, Wang, Huann-Sheng, M.D., Ph.D, Yang, Shung-Haur, M.D., Ph.D, Jiang, Jeng-Kai, M.D., Ph.D, Chen, Wei-Shone, M.D., Ph.D, Lin, Tzu-Chen, M.D, Chang, Shih-Ching, M.D., Ph.D
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-07-2014; Elsevier Limited
• Subjects: Abdomen; Adenocarcinoma - blood; Adenocarcinoma - therapy; Adult; Aged; Aged, 80 and over; Antigens; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Cancer therapies; Carcinoembryonic antigen; Carcinoembryonic Antigen - blood; CEA reduction ratio; Chemoradiotherapy, Adjuvant; Chemotherapy; Colorectal cancer; Confidence intervals; Disease-Free Survival; Dose Fractionation; Female; Follow-Up Studies; Hospitals; Humans; Leucovorin - administration & dosage; Male; Medical prognosis; Metastasis; Middle Aged; Multivariate Analysis; Preoperative chemoradiotherapy; Prognosis; Radiation therapy; Rectal cancer; Rectal Neoplasms - blood; Rectal Neoplasms - therapy; Rectum - surgery; Retrospective Studies; Surgery; Tegafur - administration & dosage; Treatment Outcome; Uracil - administration & dosage; Carcinoembryonic antigen; CEA reduction ratio; Rectal cancer; Preoperative chemoradiotherapy
• ISSN: 0002-9610; 1879-1883
• DOI: 10.1016/j.amjsurg.2013.08.054

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.