title: Value of serial carcinoembryonic antigen levels in patients with resectable adenocarcinoma of the esophagus and stomach.
abstract: BACKGROUND
  Adenocarcinomas of the esophagus and the stomach are highly virulent and remain a major health problem worldwide; 5-year survival rates have not changed in the past 30 years. Recently, preoperative chemotherapy has been used to treat these adenocarcinomas. The authors evaluated the usefulness of serial serum carcinoembryonic antigen (CEA) levels in diagnosing these patients and compared the prognosis of patients with high or normal CEA levels.
  
  
  METHODS
  Ninety consecutive patients with potentially resectable adenocarcinoma of the esophagus or stomach treated with preoperative chemotherapy were evaluated. Serum CEA levels were determined before registration, after each chemotherapy course, every 3 months for the first year after completion of all therapy, and every 6 months thereafter for 5 years.
  
  
  RESULTS
  The CEA positivity rate before chemotherapy was 22.2% (20/90); after chemotherapy, it dropped to 10.9% (9/82). An increasing CEA level predicted relapse and correlated well with liver, lung, or pleural involvement in some patients. Most patients with peritoneal involvement did not show elevated levels of CEA. Clinical responses correlated with declining levels of CEA in the patients who showed a negative conversion in CEA level after chemotherapy.
  
  
  CONCLUSIONS
  An elevated serum CEA level enabled early detection of relapse in the absence of clinical symptoms in patients with adenocarcinoma of the esophagus or the stomach. The level of CEA was also useful in monitoring the response to chemotherapy in patients who had a high CEA level before treatment. Although the pre- and postchemotherapy CEA-positive group had a higher relapse rate than that of other group, the CEA level did not predict resectability or survival. Future research with labeled monoclonal anti-CEA antibodies may prove useful for certain groups of patients.
authors: Department of Gastrointestinal Medical Oncology and Digestive Diseases, University of Texas M. D. Anderson Cancer Center, Houston 77030-4095.
authors: Y H
authors: YH
authors: Kim
authors: J A
authors: JA
authors: Ajani
authors: D M
authors: DM
authors: Ota
authors: P
authors: P
authors: Lynch
authors: J A
authors: JA
authors: Roth
mesh_terms: D000230:Adenocarcinoma / Q000097:blood* / Q000188:drug therapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002272:Carcinoembryonic Antigen / Q000097:blood*; D004938:Esophageal Neoplasms / Q000097:blood* / Q000188:drug therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care; D011379:Prognosis; D013274:Stomach Neoplasms / Q000097:blood* / Q000188:drug therapy
chemical_list: D002272:Carcinoembryonic Antigen