PURPOSE: This study was conducted to evaluate the significance of carcinoembryonic antigen (CEA) level as a predictor for tumor response to chemoradiotherapy (CRT) and a prognosticator for survival in Asian patients with advanced rectal cancer. MATERIALS AND METHODS: We enrolled 345 patients with primary rectal cancer who had undergone preoperative CRT and total mesorectal excision. We analyzed clinicopathological factors that could be associated with pathologically complete response (ypCR) and disease-free survival (DFS). RESULTS: A cutoff level of 5 ng/mL (p = 0.002) for CEA was found to be significant for prediction of ypCR. Increased CEA level (p = 0.025) was a significant negative predictor of ypCR after CRT in patients with rectal cancer. The 5-year DFS rate was significantly higher in the CEA ≤5-ng/mL group than in the CEA >5-ng/mL group (73.2 vs. 60.9 %, p = 0.002). This is mainly due to the higher chance of distant recurrence (p = 0.013), not locoregional recurrence (p = 0.732), in the CEA >5-ng/mL group. CONCLUSIONS: Elevated CEA (>5 ng/mL) is a negative predictor of ypCR and has a negative impact on DFS in Asian rectal cancer patients who underwent preoperative CRT and surgery due to an increased chance of distant recurrences.
PURPOSE: This study was conducted to evaluate the significance of carcinoembryonic antigen (CEA) level as a predictor for tumor response to chemoradiotherapy (CRT) and a prognosticator for survival in Asian patients with advanced rectal cancer. MATERIALS AND METHODS: We enrolled 345 patients with primary rectal cancer who had undergone preoperative CRT and total mesorectal excision. We analyzed clinicopathological factors that could be associated with pathologically complete response (ypCR) and disease-free survival (DFS). RESULTS: A cutoff level of 5 ng/mL (p = 0.002) for CEA was found to be significant for prediction of ypCR. Increased CEA level (p = 0.025) was a significant negative predictor of ypCR after CRT in patients with rectal cancer. The 5-year DFS rate was significantly higher in the CEA ≤5-ng/mL group than in the CEA >5-ng/mL group (73.2 vs. 60.9 %, p = 0.002). This is mainly due to the higher chance of distant recurrence (p = 0.013), not locoregional recurrence (p = 0.732), in the CEA >5-ng/mL group. CONCLUSIONS: Elevated CEA (>5 ng/mL) is a negative predictor of ypCR and has a negative impact on DFS in Asian rectal cancerpatients who underwent preoperative CRT and surgery due to an increased chance of distant recurrences.
Authors: Jong Hoon Lee; Dae Yong Kim; Taek-Keun Nam; Sei-Chul Yoon; Doo Seok Lee; Ji Won Park; Jae Hwan Oh; Hee Jin Chang; Mee Sun Yoon; Jae-Uk Jeong; Hong Seok Jang Journal: Int J Radiat Oncol Biol Phys Date: 2012-04-24 Impact factor: 7.038
Authors: C J Kim; T J Yeatman; D Coppola; A Trotti; B Williams; J S Barthel; W Dinwoodie; R C Karl; J Marcet Journal: Ann Surg Date: 2001-09 Impact factor: 12.969
Authors: Scott R Schell; Robert A Zlotecki; William M Mendenhall; Robert W Marsh; J Nicolas Vauthey; Edward M Copeland Journal: J Am Coll Surg Date: 2002-05 Impact factor: 6.113
Authors: Jeong Won Lee; Jong Hoon Lee; Byoung Yong Shim; Sung Hwan Kim; Mi-Joo Chung; Bong-Hyeon Kye; Hyung Jin Kim; Hyeon Min Cho; Hong Seok Jang Journal: Medicine (Baltimore) Date: 2015-08 Impact factor: 1.889