The prognostic significance and treatment modality for elevated pre- and postoperative serum CEA in colorectal cancer patients.
10.4174/astr.2016.91.4.165
- Author:
Kwan Mo YANG
1
;
In Ja PARK
;
Chan Wook KIM
;
Seon Ae ROH
;
Dong Hyung CHO
;
Jin Cheon KIM
Author Information
1. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. jckim@amc.seoul.kr
- Publication Type:Original Article
- Keywords:
Serum carcinoembryonic antigens;
Colorectal neoplasms;
Recurrence;
Survival
- MeSH:
Colorectal Neoplasms*;
Humans;
Recurrence;
Survival Rate
- From:Annals of Surgical Treatment and Research
2016;91(4):165-171
- CountryRepublic of Korea
- Language:English
-
Abstract:
PURPOSE: The purpose of this study was to evaluate the prognostic significance of serum CEA (s-CEA) changes in colorectal cancer (CRC) patients with sustained elevated postoperative s-CEA levels. METHODS: Between January 1999 and December 2008, 9,380 CRC patients underwent surgery. Curative resection was performed in 1,242 CRC patients with high preoperative s-CEA levels (>6 ng/mL). High s-CEA levels were normalized in 924 patients (74.4%) within 2 weeks from surgery, whereas high s-CEA levels were persistent in 318 patients (25.6%). Patients were divided into 2 groups according to their postoperative s-CEA levels: group 1 (37 patients with a 1-year postoperative s-CEA>6 ng/mL) and group 2 (281 patients with a 1-year postoperative s-CEA≤6 ng/mL). RESULTS: A postoperative recurrence was identified in 24 patients (64.9%) in group 1 and 65 patients (23.1%) in group 2 (P < 0.001). A curative resection after recurrence was performed in 22 patients (33.8%) from group 2, but no patients from group 1 (P = 0.001). The 5-year overall survival and time to recurrence were significantly lower in patients with recurrent cancer in group 1 (P < 0.001). CONCLUSION: Patients with persistent elevated postoperative s-CEA levels are at high risk for recurrence and a low survival rate. More intensive surveillance of patients with high postoperative s-CEA levels should be mandatory.
