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29.05.2018 | Original Article | Ausgabe 10/2018

Journal of Gastrointestinal Surgery 10/2018

Prognostic Role of Carcinoembryonic Antigen Level after Preoperative Chemoradiotherapy in Patients with Rectal Cancer

Zeitschrift:
Journal of Gastrointestinal Surgery > Ausgabe 10/2018
Autoren:
Jung Wook Huh, Seong Hyeon Yun, Seok Hyung Kim, Yoon Ah Park, Yong Beom Cho, Hee Cheol Kim, Woo Yong Lee, Hee Chul Park, Doo Ho Choi, Joon Oh Park, Young Suk Park, Ho-Kyung Chun
Wichtige Hinweise
Definition of Authorship
- Substantial contributions to the conception or design of the work (JWH and SHY) or the acquisition, analysis, or interpretation of data for the work (all authors); AND
- Drafting the work or revising it critically for important intellectual content (all authors); AND
- Final approval of the version to be published (all authors); AND
- Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved (all authors).

Abstract

Background

The prognostic role of post-chemoradiotherapy (CRT) carcinoembryonic antigen (CEA) level is not clear. We evaluated the prognostic significance of post-CRT CEA level in patients with rectal cancer after preoperative CRT.

Methods

We reviewed 659 consecutive patients who underwent preoperative CRT and total mesorectal excision for non-metastatic rectal cancer. Patients were categorized into two groups according to post-CRT serum CEA level: low CEA (< 5 ng/mL) and high CEA (≥ 5 ng/mL).

Results

Median post-CRT CEA level was 1.7 ng/mL (range, 0.1–207.0). A high post-CRT level was significantly associated with ypStage, ypT category, tumor regression grade, and pre-CRT CEA level. The 5-year overall survival rate of the 659 patients was 87.8% with a median follow-up period of 57.0 months (range, 1.4–176.4). When the post-CRT CEA groups were divided into groups according to pre-CRT CEA level, the 5-year overall survival rates were significantly different (P < 0.001 and P = 0.001, respectively). Post-CRT CEA level was an independent prognostic factor for overall survival. Multivariate analysis revealed that operation method, differentiation, perineural invasion, postoperative chemotherapy, tumor regression grade, and post-CRT CEA level were independent prognostic factors for overall survival.

Conclusion

The level of serum CEA after preoperative CRT was an independent prognostic factor for overall survival in patients with rectal cancer.

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