Byung Chul Kim1,2, Jung Hoon Bae1, Sun Min Park3, Dae Youn Won1, In Kyu Lee4. 1. Departments of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seocho-gu, Seoul, 06591, Republic of Korea. 2. Graduate School of Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 3. Departments of Surgery, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 4. Departments of Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seocho-gu, Seoul, 06591, Republic of Korea. cmcgslee@catholic.ac.kr.
Abstract
PURPOSE: Our previous study reported that carcinoembryonic antigen (CEA) levels in peritoneal fluid were significantly correlated with the prevalence of peritoneal carcinomatosis (PC) in colorectal cancer (CRC). The purpose of this study was a long-term follow up of the author's previous study, as well as the identification of correlations with the known risk factors of PC and the comparison of the predictive power of PC in CRC. METHODS: A total of 495 patients without PC who underwent CRC operations at St. Mary's Hospital, The Catholic University of Korea, from January 2006 to November 2014 were included in this study. Tumor markers of peritoneal fluid sampled at the beginning of each operation were prospectively analyzed and compared with the known risk factors for PC in CRC. RESULTS: Multivariate analysis of PC revealed that T4 cancer (OR 5.143, 95% CI 1.400-18.897, p = 0.014), T3 mucinous cancer (OR 17.480, 95% CI 1.577-193.714, p = 0.020), obstructed tumors (OR 6.030, 95% CI 1.627-22.343, p = 0.007), and peritoneal fluid CEA above 5 ng/dl (OR 4.073, 95% CI 1.315-12.615, p = 0.015) were significant risk factors. T4 cancer, obstructed tumors, and peritoneal fluid CEA above 5 ng/dl showed correlations with cancer-free survival. Generally, higher CEA levels in peritoneal fluid were correlated with previously known risk factors for PC in CRC. CONCLUSION: Peritoneal fluid CEA has predictive value for PC and prognostic value in CRC. Therefore, we recommend routinely performing ascites CEA analysis in colorectal cancer surgery.
PURPOSE: Our previous study reported that carcinoembryonic antigen (CEA) levels in peritoneal fluid were significantly correlated with the prevalence of peritoneal carcinomatosis (PC) in colorectal cancer (CRC). The purpose of this study was a long-term follow up of the author's previous study, as well as the identification of correlations with the known risk factors of PC and the comparison of the predictive power of PC in CRC. METHODS: A total of 495 patients without PC who underwent CRC operations at St. Mary's Hospital, The Catholic University of Korea, from January 2006 to November 2014 were included in this study. Tumor markers of peritoneal fluid sampled at the beginning of each operation were prospectively analyzed and compared with the known risk factors for PC in CRC. RESULTS: Multivariate analysis of PC revealed that T4 cancer (OR 5.143, 95% CI 1.400-18.897, p = 0.014), T3 mucinous cancer (OR 17.480, 95% CI 1.577-193.714, p = 0.020), obstructed tumors (OR 6.030, 95% CI 1.627-22.343, p = 0.007), and peritoneal fluid CEA above 5 ng/dl (OR 4.073, 95% CI 1.315-12.615, p = 0.015) were significant risk factors. T4 cancer, obstructed tumors, and peritoneal fluid CEA above 5 ng/dl showed correlations with cancer-free survival. Generally, higher CEA levels in peritoneal fluid were correlated with previously known risk factors for PC in CRC. CONCLUSION: Peritoneal fluid CEA has predictive value for PC and prognostic value in CRC. Therefore, we recommend routinely performing ascitesCEA analysis in colorectal cancer surgery.
Authors: P Vogel; J Rüschoff; S Kümmel; H Zirngibl; F Hofstädter; W Hohenberger; K W Jauch Journal: Dis Colon Rectum Date: 2000-01 Impact factor: 4.585
Authors: Vic J Verwaal; Serge van Ruth; Eeclo de Bree; Gooike W van Sloothen; Harm van Tinteren; Henk Boot; Frans A N Zoetmulder Journal: J Clin Oncol Date: 2003-10-15 Impact factor: 44.544
Authors: In Kyu Lee; Do Hyoung Kim; D Lee Gorden; Yoon Suk Lee; Na Young Sung; Gyeoung-Sin Park; Hyung Jin Kim; Won Kyung Kang; Jong Kyung Park; Chang Hyeok Ahn; Jun-Gi Kim; Hae Myung Jeon; Seong Taek Oh Journal: Ann Surg Oncol Date: 2009-02-03 Impact factor: 5.344