Ann Coloproctol.  2013 Jun;29(3):115-122. 10.3393/ac.2013.29.3.115.

Prognostic Significance of the Decreased Rate of Perioperative Serum Carcinoembryonic Antigen Level in the Patients With Colon Cancer After a Curative Resection

• Jung TD
• Yoo JH
• Lee MJ
• Park HK
• Shin JH
• An MS
• Ha TK
• Kim KH
• Bae KB
• Kim TH
• Choi CS
• Oh MK
• Hong KH

• KMID: 1971122
• DOI: http://doi.org/10.3393/ac.2013.29.3.115

Abstract

PURPOSE
The serum level of carcinoembryonic antigen (CEA) is a clinical prognostic factor in the follow-up evaluation of patients with colon cancer. We aimed to evaluate the prognostic significance of the rate of decrease of the perioperative serum CEA level in patients with colon cancer after a curative resection.
METHODS
A total of 605 patients who underwent a curative resection for colon cancer between January 2000 and December 2007 were enrolled retrospectively. The rate of decrease was calculated using the following equation: ([preoperative CEA - postoperative CEA]/[preoperative CEA] x100).
RESULTS
In the group with a preoperative serum CEA level of >5 ng/mL, the normalized group with a postoperative serum CEA level of < or =5 ng/mL showed a better overall survival (OS) rate and disease-free survival (DFS) rate than those of the non-normalized group (P < or = 0.0001). The "cutoff values" of the rate of decrease in the perioperative serum CEA that determined the OS and the DFS were 48.9% and 50.8%, respectively. In the multivariate analysis of preoperative serum CEA levels >5 ng/mL, the prognostic factors for the OS and the DFS were the cutoff value (P < 0.0001) and the pN stage (P < 0.0001).
CONCLUSION
A rate of decrease of more than 50% in the perioperative serum CEA level, as well as the normalization of the postoperative serum CEA level, may be useful factors for determining a prognosis for colon cancer patients with high preoperative CEA levels.

Keyword

Colon neoplasms; Carcinoembryonic antigen; Prognostic factor

MeSH Terms

Carcinoembryonic Antigen
Colon
Colonic Neoplasms
Disease-Free Survival
Follow-Up Studies
Humans
Multivariate Analysis
Prognosis
Retrospective Studies
Carcinoembryonic Antigen