Chih-Sheng Huang1, Jen-Kou Lin1, Ling-Wei Wang2, Wen-Yih Liang3, Chun-Chi Lin1, Yuan-Tzu Lan1, Huann-Sheng Wang1, Shung-Haur Yang1, Jeng-Kai Jiang1, Wei-Shone Chen1, Tzu-Chen Lin1, Shih-Ching Chang4. 1. Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan. 2. School of Medicine, National Yang-Ming University, Taiwan; Cancer Center, Taipei Veterans General Hospital, Taiwan. 3. School of Medicine, National Yang-Ming University, Taiwan; Department of Pathology, Taipei Veterans General Hospital, Taiwan. 4. Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan. Electronic address: changsc@vghtpe.gov.tw.
Abstract
BACKGROUND: Carcinoembryonic antigen (CEA) is the most widely used tumor marker for colorectal cancer. This study aimed to investigate the role of CEA reduction ratio after preoperative chemoradiotherapy (CRT). METHODS: We enrolled 284 patients who underwent preoperative CRT followed by radical surgical resection. Patients were divided into 3 groups: serum CEA levels before CRT (pre-CRT CEA) less than 5 ng/mL (group 1); pre-CRT CEA of 5 ng/mL or more with CEA reduction ratio of 50% or more (group 2); and pre-CRT CEA of 5 ng/mL or more with CEA reduction ratio less than 50% (group 3). RESULTS: The 5-year disease-free survival (DFS) rate was not different between groups 1 (71.8%) and 2 (69.4%) but was significantly lower in group 3 (49.5%). CEA group, lymph node status after CRT (ypN) stage, and histologic type were independent prognostic factors for DFS on multivariate analysis. CONCLUSIONS: CEA reduction ratio might be an independent prognostic factor for DFS in rectal cancer patients treated with preoperative CRT and radical surgery.
BACKGROUND:Carcinoembryonic antigen (CEA) is the most widely used tumor marker for colorectal cancer. This study aimed to investigate the role of CEA reduction ratio after preoperative chemoradiotherapy (CRT). METHODS: We enrolled 284 patients who underwent preoperative CRT followed by radical surgical resection. Patients were divided into 3 groups: serum CEA levels before CRT (pre-CRT CEA) less than 5 ng/mL (group 1); pre-CRT CEA of 5 ng/mL or more with CEA reduction ratio of 50% or more (group 2); and pre-CRT CEA of 5 ng/mL or more with CEA reduction ratio less than 50% (group 3). RESULTS: The 5-year disease-free survival (DFS) rate was not different between groups 1 (71.8%) and 2 (69.4%) but was significantly lower in group 3 (49.5%). CEA group, lymph node status after CRT (ypN) stage, and histologic type were independent prognostic factors for DFS on multivariate analysis. CONCLUSIONS:CEA reduction ratio might be an independent prognostic factor for DFS in rectal cancerpatients treated with preoperative CRT and radical surgery.
Authors: Peter Jo; Azadeh Azizian; Junius Salendo; Frank Kramer; Markus Bernhardt; Hendrik A Wolff; Jens Gruber; Marian Grade; Tim Beißbarth; B Michael Ghadimi; Jochen Gaedcke Journal: Int J Mol Sci Date: 2017-05-27 Impact factor: 5.923