Doubling time of carcinoembryonic antigen is a significant prognostic factor after the surgical resection of locally recurrent rectal cancer.
BACKGROUND
Patients undergoing a curative rectal cancer resection have a risk of developing locoregional recurrence. A curative resection for local recurrence is the option of improvement in prognosis. However, a curative resection is sometimes too invasive and should be considered in selected patients.


METHODS
A total of 43 patients with locally recurrent rectal cancer who had been treated by operation between 1989 and 2007 were retrospectively reviewed and the factors, including doubling time of carcinoembryonic antigen (CEA-dt), were analyzed.


RESULTS
The 5-year overall survival rate after the operation for local recurrence was 50.8%. Gender, presence of distant metastasis, tumor size, CEA-dt and curability were found to be significant prognostic factors. A multivariate analysis demonstrated the presence of distant metastasis, CEA-dt and tumor size to be significant prognostic factors for overall survival. The 5-year overall survival rates of patients with a CEA-dt > or =150 days and a tumor size <5 cm were 76.9%.


CONCLUSIONS
The tumor size and CEA-dt were useful prognostic factors that were recognizable before surgery. Patients with locally recurrent rectal cancer with a CEA-dt > or =150 days and a recurrent tumor size <5 cm are considered to be good candidates for surgery.
Tanaka
Koji
K
Department of Surgery, Osaka Medical Center for Cancer and Cardiovascular Diseases, Osaka, Japan.
Noura
Shingo
S
Ohue
Masayuki
M
Seki
Yosuke
Y
Yamada
Terumasa
T
Miyashiro
Isao
I
Ohigashi
Hiroaki
H
Yano
Masahiko
M
Ishikawa
Osamu
O
Murata
Kohei
K
Kameyama
Masao
M
Imaoka
Shingi
S
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000276:immunology*; D011379:Prognosis; D012004:Rectal Neoplasms / Q000276:immunology* / Q000401:mortality / Q000601:surgery*; D012189:Retrospective Studies; D016019:Survival Analysis
D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen