Clinical Significance of Serial Serum Carcinoembryonic Antigen Values for Treating Rectal Cancer with Preoperative Chemoradiotherapy.
10.3393/jksc.2012.28.4.205
- Author:
Young Jae RYU
1
;
Chang Hyun KIM
;
Hun Jin KIM
;
Hyo KANG
;
Sang Woo LIM
;
Jung Wook HUH
;
Jae Kyun JU
;
Young Jin KIM
;
Hyeong Rok KIM
Author Information
1. Division of Colorectal Surgery, Department of Surgery, Chonnam National University Medical School, Gwangju, Korea. drkhr@jnu.ac.kr
- Publication Type:Original Article
- Keywords:
Rectal neoplasms;
Carcinoembryonic antigen;
Chemoradiotherapy
- MeSH:
Carcinoembryonic Antigen;
Chemoradiotherapy;
Disease-Free Survival;
Humans;
Multivariate Analysis;
Prognosis;
Rectal Neoplasms;
Recurrence
- From:Journal of the Korean Society of Coloproctology
2012;28(4):205-212
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: Preoperative chemoradiotherapy is now widely accepted to treat rectal cancer; however, the prognosis for rectal cancer patients during and after chemoradiotherapy must be determined. The aim of this study was to evaluate the serial serum carcinoembryonic antigen (s-CEA) samples in patients with rectal cancer who underwent radical surgery after concurrent chemoradiotherapy (CRT). METHODS: This study evaluated 236 patients with rectal cancer who received preoperative CRT followed by curative surgery between June 2005 and June 2010. We measured the patient's s-CEA levels pre-CRT, post-CRT and post-surgery. Patients were classified into four groups according to their s-CEA concentrations (group 1, high, high, high; group 2, high, high, normal; group 3, high, normal, normal; group 4, normal, normal, normal). We analyzed the clinicopathologic factors and the outcomes among these groups. RESULTS: Of the 236 patients, 12 were in group 1, 31 were in group 2, 67 were in group 3, and 126 were in group 4. The 3-year disease-free survival rate in group 1 was poorer than those in group 3 (P = 0.007) and group 4 (P < 0.001). In a univariate analysis, type of surgery, clinical N stage, pathologic T or N stage, lymphovascular invasion, perineural invasion, and CEA group were prognostic factors. A multivariate analysis revealed that type of surgery, pathologic T stage, and lymphovascular invasion were independent prognostic factors; however, no statistical significance was associated with the CEA group. CONCLUSION: High pre-CRT, post-CRT, and post-surgery s-CEA levels in patients with rectal cancer were associated with high rates of systemic recurrence and poor survival. Therefore, patients with sustained high s-CEA levels during CRT require careful monitoring after surgery.
