Prognostic Role of Carcinoembryonic Antigen (CEA) in Colorectal Carcinoma

Abstract

Background: Preoperative carcinoembryonic antigen (CEA) level is considered as a factor predictive of survival in colorectal cancer patients. Patients with normal (<5 ng/ml) or lower pre- operative CEA levels were reported to have significantly longer survival. Objective: To evaluate the prognostic significance of preoperative CEA levels of patients with colorectal cancer in Taiwan. Methods: Between Jan 2016 and Dec 2017, 39 patients with histologically confirmed colorectal cancers were evaluated retrospectively at the General Surgery Department of Hayatabad Medical Complex Peshawar. All patients had undergone potentially curative surgery. Patients with metastatic diseases were not included. 5-Fluorouracil-based adjuvant chemotherapy was administered if the patients had Dukes’ C disease. Reference to the Dukes’ classification was according to the classical criteria described in 1932 for carcinoma of the rectum and adapted for use in colonic tumors. Data on gender, age, degree of tumor differentiation, location of the tumor, tumor size, lymph node metastasis, penetration of the bowel wall and preoperative CEA levels were analyzed to deter mine their association with survival. Blood samples for CEA measurement were taken a few days before operation and were analyzed using the radioimmunoassay method. Results: Total 39 patients were included in the study. Age ranged between 30-80 years with a mean age of 55 years. There were 26(66.7%) males and 13(33.3%) females, with male to female ratio of 2:1. Patients with preoperative CEA levels of <5 ng/ml had significantly longer survival than those with preoperative CEA levels of >5 ng/ml. The median 5 years survival rate for patients with preoperative CEA <5 ng/ml was 51.2 months, while 35.5 years for >5 ng/ml patients respectively (p < 0.001). The tumour was primary located at the colon in 23(59%) while the rest was found at the rectum 16(41%). Tumour size was <2cm in 25(64.1%) and >2cm in 14(35.9%) patients. ...............