IDDF2018-ABS-0152 The preoperative cea can be an independent predictive factor for colorectal cancer patients after curative resection in long-term outcome

Abstract

Background The preoperative carcinoembryonic antigen (CEA) level as a prognostic factor of colorectal cancer (CRC) has been in debate. Methods A consecutive case series were collected from our database of CRC from 1995 to 2010. Clinicopathological factors were matched by propensity score methods with calliper width of 0.05 and a 1:4 ratio. Long-term overall survival (OS) and disease-specific survival (DSS) were analysed and compared between 3 different serum CEA levels. Results A total number of 9634 patients were included initially. After exclusion and matching, a number of 6099 cases were matched by propensity score matching methods with median follow-up period 86 months. The survival analysis showed poor OS in elevated serum CEA groups than normal CEA level (5 year survival rate: 75% vs. 66% vs. 61%) and was also presented in both subgroups divided by lymph node (LN) stage (LN positive: 69% vs. 56% vs. 50%, LN negative: 83% vs. 77% vs. 72%) but not between elevated groups. In contrast, DSS showed significantly poor outcome between each group and was proportional to serum CEA elevation (5 year survival rate: 83% vs. 76% vs. 69%, p In multivariate Cox regression model after adjusted with TNM stage, smoking, DM, renal insufficiency, liver cirrhosis and other factors, elevated CEA showed higher risk in DSS (5 to 10 ng/ml HR=1.540,>10 ng/ml HR=1.910, both p Conclusions Elevated preoperative serum CEA can be an independent prognostic factor for stage I to III CRC patients after curative resection with poor long-term overall and oncological outcome.