title: Preoperative carcinoembryonic antigen level predicts prognosis in patients with pseudomyxoma peritonei treated with cytoreductive surgery and hyperthermic intraperitoneal chemotherapy.
abstract: BACKGROUND
  Even though management of pseudomyxoma peritonei (PMP) was improved with cytoreductive surgery (CRS) and hyperthermic chemotherapy (HIPEC), several aspects of PMP still need to be optimized, including patient selection for surgery and prognostic factors. We assessed the role of preoperative carcinoembryonic antigen (CEA) levels in PMP patients treated with CRS and HIPEC.
  
  
  METHODS
  A total of 449 PMP patients with documented preoperative CEA levels referred to our center between 2005 and 2011 underwent CRS and HIPEC. The association between CEA levels and characteristics of patients with PMP was assessed with χ (2) test, linear correlation, and logistic regression analyses. Survival analysis was performed with Cox proportional hazard model.
  
  
  RESULTS
  Median age was 55 (range 19-84) years. There were 245 (54.5 %) females and 204 (45.5 %) males. Preoperative CEA levels were elevated in 328 (73 %, sensitivity) patients with PMP. Preoperative CEA levels were also related to peritoneal cancer index (P < 0.0001), cytoreductive surgery scores (P < 0.0001), progress free survival (P < 0.001) and overall survival (P < 0.001) in patients with PMP.
  
  
  CONCLUSIONS
  Our results indicated that preoperative CEA levels are useful in predicting the extent of disease and surgical success as well as progress-free and overall survival in patients with PMP treated with cytoreductive surgery and HIPEC.
authors.affiliation: NPO Organization to Support Peritoneal Dissemination Treatment, 1-26, Harukimotomachi, Kishiwada City, Osaka, 596-0032, Japan. drecanbay@gmail.com
authors.forename: Emel
authors.initials: E
authors.lastname: Canbay
authors.forename: Haruaki
authors.initials: H
authors.lastname: Ishibashi
authors.forename: Shouzou
authors.initials: S
authors.lastname: Sako
authors.forename: Akiyoshi
authors.initials: A
authors.lastname: Mizumoto
authors.forename: Masamitsu
authors.initials: M
authors.lastname: Hirano
authors.forename: Masumi
authors.initials: M
authors.lastname: Ichinose
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Takao
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yonemura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood*; D010478:Chemotherapy, Cancer, Regional Perfusion; D005260:Female; D006801:Humans; D006979:Hyperthermia, Induced; D007274:Injections, Intraperitoneal; D008297:Male; D008875:Middle Aged; D010534:Peritoneal Neoplasms / Q000097:blood* / Q000188:drug therapy* / Q000601:surgery*; D011237:Predictive Value of Tests; D011379:Prognosis; D011553:Pseudomyxoma Peritonei / Q000097:blood* / Q000188:drug therapy* / Q000601:surgery*; D012189:Retrospective Studies; D015996:Survival Rate; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen