title: Prognostic significance of the decreased rate of perioperative serum carcinoembryonic antigen level in the patients with colon cancer after a curative resection.
abstract: OBJECTIVE
  The serum level of carcinoembryonic antigen (CEA) is a clinical prognostic factor in the follow-up evaluation of patients with colon cancer. We aimed to evaluate the prognostic significance of the rate of decrease of the perioperative serum CEA level in patients with colon cancer after a curative resection.
  
  
  METHODS
  A total of 605 patients who underwent a curative resection for colon cancer between January 2000 and December 2007 were enrolled retrospectively. The rate of decrease was calculated using the following equation: ([preoperative CEA - postoperative CEA]/[preoperative CEA] ×100).
  
  
  RESULTS
  In the group with a preoperative serum CEA level of >5 ng/mL, the normalized group with a postoperative serum CEA level of ≤5 ng/mL showed a better overall survival (OS) rate and disease-free survival (DFS) rate than those of the non-normalized group (P ≤ 0.0001). The "cutoff values" of the rate of decrease in the perioperative serum CEA that determined the OS and the DFS were 48.9% and 50.8%, respectively. In the multivariate analysis of preoperative serum CEA levels >5 ng/mL, the prognostic factors for the OS and the DFS were the cutoff value (P < 0.0001) and the pN stage (P < 0.0001).
  
  
  CONCLUSIONS
  A rate of decrease of more than 50% in the perioperative serum CEA level, as well as the normalization of the postoperative serum CEA level, may be useful factors for determining a prognosis for colon cancer patients with high preoperative CEA levels.
authors.affiliation: Department of Surgery, Inje University Busan Paik Hospital, Inje University College of Medicine, Busan, Korea.
authors.forename: Tae Doo
authors.initials: TD
authors.lastname: Jung
authors.forename: Jong Han
authors.initials: JH
authors.lastname: Yoo
authors.forename: Min Jae
authors.initials: MJ
authors.lastname: Lee
authors.forename: Ha Kyung
authors.initials: HK
authors.lastname: Park
authors.forename: Jae Ho
authors.initials: JH
authors.lastname: Shin
authors.forename: Min Sung
authors.initials: MS
authors.lastname: An
authors.forename: Tae Kwun
authors.initials: TK
authors.lastname: Ha
authors.forename: Kwang Hee
authors.initials: KH
authors.lastname: Kim
authors.forename: Ki Beom
authors.initials: KB
authors.lastname: Bae
authors.forename: Tae Hyeon
authors.initials: TH
authors.lastname: Kim
authors.forename: Chang Soo
authors.initials: CS
authors.lastname: Choi
authors.forename: Min Kyung
authors.initials: MK
authors.lastname: Oh
authors.forename: Kwan Hee
authors.initials: KH
authors.lastname: Hong
keywords: Carcinoembryonic antigen; Colon neoplasms; Prognostic factor