title: The predictive value of preoperative carcinoembryonic antigen level in the prognosis of colon cancer.
abstract: BACKGROUND
  We evaluated factors associated with an increased preoperative carcinoembryonic antigen (CEA) level for colon cancer patients undergoing elective curative surgery and assessed whether this was associated with prognosis when accounting for other potential confounders.
  
  
  METHODS
  Prospectively accrued data of patients with stage I, II, and III colon cancer undergoing surgery (1980-2008) were retrieved retrospectively. Patients with a preoperative CEA level greater than 5 ng/mL (group B) were compared with those with a CEA level of 5 ng/mL or less (group A).
  
  
  RESULTS
  There were 651 patients (379 men) with a median age of 67 years (range, 21-94 y) and a median follow-up period of 5.9 years. Groups A (n = 451) and B (n = 200) had similar ages and tumor locations. Group B had larger tumors; more patients with T3 and N1/N2; and more patients with stage II/III tumors, and hence greater use of chemotherapy (P = .04). On multivariate analysis, patient age, tumor stage, and differentiation were associated with oncologic outcomes. A CEA level greater than 5 ng/mL was not associated independently with recurrence, recurrence-free survival (P = .47), or overall survival (P = .3).
  
  
  CONCLUSIONS
  An increased preoperative CEA level is a marker for a more advanced tumor stage. For adequately staged patients, a high preoperative CEA level is not associated independently with oncologic outcomes.
authors.affiliation: Cleveland Clinic Foundation, Department of Colorectal Surgery, Digestive Disease Institute-A30, 9500 Euclid Ave., Cleveland, OH 44195, USA.
authors.forename: Hasan T
authors.initials: HT
authors.lastname: Kirat
authors.forename: Ersin
authors.initials: E
authors.lastname: Ozturk
authors.forename: Ian C
authors.initials: IC
authors.lastname: Lavery
authors.forename: Ravi P
authors.initials: RP
authors.lastname: Kiran
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D003082:Colectomy; D003110:Colonic Neoplasms / Q000276:immunology* / Q000473:pathology* / Q000601:surgery; D018572:Disease-Free Survival; D017558:Elective Surgical Procedures; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen