Yonsei Med J.  2013 Jan;54(1):116-122. 10.3349/ymj.2013.54.1.116.

Usefulness of Carcinoembryonic Antigen for Monitoring Tumor Progression during Palliative Chemotherapy in Metastatic Colorectal Cancer

• Kim G
• Jung EJ
• Ryu CG
• Hwang DY

• KMID: 1776926
• DOI: http://doi.org/10.3349/ymj.2013.54.1.116

Abstract

PURPOSE
To evaluate the efficacy of carcinoembryonic antigen (CEA) measurement for monitoring tumor progression during palliative chemotherapy in metastatic colorectal cancer.
MATERIALS AND METHODS
Forty-eight patients with initially unresectable metastatic colorectal cancer (n=26, 54.2%) or recurrent unresectable metastatic colorectal cancer (n=22, 45.8%) received FOLFOX-4 chemotherapy for palliation. Serum CEA levels and carbohydrate antigen 19-9 levels were measured and computed tomography (CT) studies were performed prior to chemotherapy and after 3 cycles of chemotherapy. From the CT images, tumor responses were evaluated according to the Response Evaluation Criteria in Solid Tumors criteria and categorized as complete response, partial response, stable disease, and progressive disease. The sensitivity, specificity, positive predictive value, negative predictive value, and diagnostic accuracy of tumor marker assessments for determining tumor response were calculated.
RESULTS
The sensitivity, specificity and diagnostic accuracy of CEA assessment for prediction of disease progression were 50%, 77% and 69%, respectively. When the patients were dichotomized according to baseline CEA level, the initially elevated CEA group showed higher sensitivity and higher diagnostic accuracy compared to the initially normal CEA group (sensitivity=67% vs. 20%; diagnostic accuracy=71% vs. 62%).
CONCLUSION
CEA assessment could be useful for monitoring tumor progression during palliative chemotherapy in only patients with initially elevated CEA level.

Keyword

Carcinoembryonic antigen; disease progression; palliative treatment; chemotherapy; metastatic; colorectal cancer

MeSH Terms

Adult
Aged
Antineoplastic Agents/*therapeutic use
Antineoplastic Combined Chemotherapy Protocols/therapeutic use
CA-19-9 Antigen/metabolism
Carcinoembryonic Antigen/*blood
Colorectal Neoplasms/drug therapy/*metabolism
Disease Progression
Female
Fluorouracil/therapeutic use
Humans
Leucovorin/therapeutic use
Male
Middle Aged
Organoplatinum Compounds/therapeutic use
Palliative Care
Predictive Value of Tests
Recurrence
Reproducibility of Results
Sensitivity and Specificity
Tomography, X-Ray Computed
Tumor Markers, Biological/blood
Antineoplastic Agents
CA-19-9 Antigen
Carcinoembryonic Antigen
Organoplatinum Compounds
Tumor Markers, Biological
Leucovorin
Fluorouracil