Abstract
The purpose is to investigate prognosis according to serum CEA levels before and after surgery in patients with stage IIA colon cancer who do not show high-risk features. Among the patients diagnosed with colon adenocarcinoma between April 2011 and December 2017, 462 patients were confirmed as low-risk stage IIA after surgery and enrolled. The ROC curve was used to determine cut-off values of pre- and postoperative CEA. Patients were classified into three groups using these new cut-off values. All recurrence occurred in 52 of 463 patients (11.2%). However, recurrence in group H was 15.9%, which was slightly higher than the other two groups (P = 0.04). Group L and M showed 10.5% and 12.8% overall survival, group H was higher at 21.0% (P = 0.005). Recurrence was the only risk factor in group H was significantly higher in group L (HR 2.008, 95% CI, 1.123-3.589, P = 0.019). Mortality was similar to recurrence (HR 1.975, 95% CI 1.091-3.523, P = 0.044). Among patients with low-risk stage IIA colon cancer, recurrence and mortality rates were higher when perioperative serum CEA levels were above a certain level. Therefore, high CEA level should be considered a high-risk feature and adjuvant chemotherapy should be performed.
Highlights
Colorectal cancer (CRC), the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide, has steadily increasing mortality rates; it is estimated that >1,800,000 new cases of CRC occurred and that >860,000 people died of this disease in 2018 [1]
Group L and M showed 10.5% and 12.8% overall survival, group H was higher at 21.0% (P = 0.005)
Recurrence was the only risk factor in group H was significantly higher in group L (HR 2.008, 95% CI, 1.123–3.589, P = 0.019)
Summary
Colorectal cancer (CRC), the third most commonly diagnosed cancer and the second leading cause of cancer death worldwide, has steadily increasing mortality rates; it is estimated that >1,800,000 new cases of CRC occurred and that >860,000 people died of this disease in 2018 [1]. Surgery is the main treatment for early cases, but patients are often diagnosed in the advanced stages and there may be distant metastases [2]. Among patients with nodepositive CRC (stage III), it is common to perform postoperative adjuvant chemotherapy, and the effect of this treatment has already been demonstrated [3]. According to the National Comprehensive Cancer Network (NCCN) guidelines, postoperative observation is usually performed when stage IIA colon cancer is not high risk and adjuvant chemotherapy is considered an option. On the other hand, chemotherapy is the main treatment and observation is an option [4]. The purpose is to investigate prognosis according to serum CEA levels before and after surgery in patients with stage IIA colon cancer who do not show high-risk features
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
