Prognostic effect of perioperative change of serum carcinoembryonic antigen level: a useful tool for detection of systemic recurrence in rectal cancer.
BACKGROUND
The prognosis of patients even with the same stage of rectal cancer varies widely. We analyzed the capability of perioperative change of serum carcinoembryonic antigen (CEA) level for predicting recurrence and survival in rectal cancer patients.


METHODS
We reviewed 631 patients who underwent potentially curative resection for stage II or III rectal cancer. Patients were categorized into three groups according to their serum CEA concentrations on the seventh day before and on the seventh day after surgery: group A, normal CEA level (<or=5 ng/mL) in both periods; group B, increased preoperative and normal postoperative CEA; and group C, continuously increased CEA in both periods. The prognostic relevance of the CEA group was investigated by analyses of recurrence patterns and survival.


RESULTS
Stage III patients showed higher systemic recurrence (P = .001) and worse 5-year survival rates (P < .0001) for group C than for groups A and B. On multivariate analysis, the CEA group was a significant predictor for recurrence (P < .001; relative risk, 2.740; 95% confidence interval, 1.677-4.476) and survival (P = .001; relative risk, 2.174; 95% confidence interval, 1.556-3.308).


CONCLUSIONS
The perioperative serum CEA change was a useful prognostic indicator to predict for systemic recurrence and survival in stage III rectal cancer patients.
Department of Surgery, Yonsei University College of Medicine, 134 Shinchon-dong, Seodaemun-ku, Seoul, Korea.
Yoon-Ah
YA
Park
Kang Young
KY
Lee
Nam Kyu
NK
Kim
Seung Hyuk
SH
Baik
Seung Kook
SK
Sohn
Chang Whan
CW
Cho
D000230:Adenocarcinoma / Q000097:blood* / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000097:blood*; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012004:Rectal Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery; D012307:Risk Factors; D015996:Survival Rate
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen