title: Factors predicting long-term survival in colorectal cancer patients with a normal preoperative serum level of carcinoembryonic antigen.
abstract: OBJECTIVE
  The aim of this study was to determine which clinicopathological factors influenced the long-term survival after potentially curative resection of colorectal cancer patients with a normal preoperative serum level of carcinoembryonic antigen (CEA).
  
  
  METHODS
  A total of 1,732 patients who underwent curative surgery for primary nonmetastatic colorectal cancers from 1997 to 2009 were analyzed. Of these patients, 1,128 (65.1 %) had normal level of preoperative CEA (<5 ng/mL). The predicting factors for survival were analyzed.
  
  
  RESULTS
  When the serum CEA cutoff value was set at 2.4 ng/mL (median value), the high CEA groups displayed a higher percentage of older patients, males, large-diameter tumors, advanced T and N categories, and positive perineural invasion, compared to the low CEA groups. Multivariate analysis revealed that age, T category, N category, number of lymph nodes retrieved, operative method, lymphovascular invasion, perineural invasion, postoperative chemotherapy, and preoperative serum CEA level ≥ 2.4 ng/mL were independent predictors for 5-year overall survival, while tumor location, tumor size, T category, N category, lymphovascular invasion, and perineural invasion were independent predictors for 5-year disease-free survival.
  
  
  CONCLUSIONS
  Even if patients with colorectal cancer have a normal preoperative CEA before surgery, CEA may be useful for prognostic stratification using 2.4 ng/mL as the cutoff.
authors.affiliation: Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
authors.forename: Jung Wook
authors.initials: JW
authors.lastname: Huh
authors.forename: Chang Hyun
authors.initials: CH
authors.lastname: Kim
authors.forename: Sang Woo
authors.initials: SW
authors.lastname: Lim
authors.forename: Hyeong Rok
authors.initials: HR
authors.lastname: Kim
authors.forename: Young Jin
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000401:mortality* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood / Q000401:mortality* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000401:mortality* / Q000601:surgery; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D012189:Retrospective Studies; D015996:Survival Rate; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen