Abstract
This study investigated the prognostic impact of serum carcinoembryonic antigen (CEA) level in recurrent rectal cancer. We reviewed 745 patients who developed recurrence after curative treatment for rectal cancer between January 2000 and December 2012. Multivariate analyses for survival revealed that age > 60 years (p = 0.005), r-CEA ≥ 5 ng/ml (p < 0.001), disease free interval (DFI) < 12 months (p < 0.001), and palliative or conservative treatment (p < 0.001) were unfavorable factors.
Highlights
Serum carcinoembryonic antigen (CEA) is one of the most widely used tumor markers for screening test, predicting treatment response and survival, and detecting recurrence in colorectal cancer [1,2,3,4]
A Korean multi-institutional study found that patients with elevated pretreatment CEA level (pre-CEA) have lower recurrence-free survival (RFS) and overall survival (OS) than patients with normal pre-CEA (5-year RFS 74.2% vs. 63.5%, p < 0.001 and 5-year OS 86.9% vs. 81.8%, p = 0.001) among rectal cancer patients treated with neoadjuvant chemoradiotherapy (NACRT) and surgery, even after propensity score matching to control covariates including stage [11]
Www.impactjournals.com/oncotarget patients were treated with surgery alone, 219 (29.4%) with NACRT followed by surgery, 158 (21.2%) with surgery followed by postoperative chemoradiotherapy, and 8 (1.0%) with preoperative radiotherapy and surgery
Summary
Serum carcinoembryonic antigen (CEA) is one of the most widely used tumor markers for screening test, predicting treatment response and survival, and detecting recurrence in colorectal cancer [1,2,3,4]. Elevated serum CEA is found in 17~47% of colorectal cancer patients [5, 6]. Clinical significance of pre-CEA and post-NACRT CEA level, postoperative CEA level, and CEA ratio were investigated to predict prognosis of recurrent rectal cancer patients. Perez et al [12] reported that post-NACRT CEA higher than 5 ng/ml is associated with lower rate of pathological response and worse disease-free survival (DFS). Kim et al [14] noted that a reduction in the pre-CEA to post-NACRT CEA level is a favorable factor for survival in patients whose pre-CEA level was higher than 6 ng/ml
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