title: Assessment of the value of carcinoembryonic antigen reduction ratio as a prognosis factor in rectal cancer.
abstract: BACKGROUND
  Carcinoembryonic antigen (CEA) is the most widely used tumor marker for colorectal cancer. This study aimed to investigate the role of CEA reduction ratio after preoperative chemoradiotherapy (CRT).
  
  
  METHODS
  We enrolled 284 patients who underwent preoperative CRT followed by radical surgical resection. Patients were divided into 3 groups: serum CEA levels before CRT (pre-CRT CEA) less than 5 ng/mL (group 1); pre-CRT CEA of 5 ng/mL or more with CEA reduction ratio of 50% or more (group 2); and pre-CRT CEA of 5 ng/mL or more with CEA reduction ratio less than 50% (group 3).
  
  
  RESULTS
  The 5-year disease-free survival (DFS) rate was not different between groups 1 (71.8%) and 2 (69.4%) but was signiﬁcantly lower in group 3 (49.5%). CEA group, lymph node status after CRT (ypN) stage, and histologic type were independent prognostic factors for DFS on multivariate analysis.
  
  
  CONCLUSIONS
  CEA reduction ratio might be an independent prognostic factor for DFS in rectal cancer patients treated with preoperative CRT and radical surgery.
authors: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan.
authors: Chih-Sheng
authors: CS
authors: Huang
authors: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan.
authors: Jen-Kou
authors: JK
authors: Lin
authors: School of Medicine, National Yang-Ming University, Taiwan; Cancer Center, Taipei Veterans General Hospital, Taiwan.
authors: Ling-Wei
authors: LW
authors: Wang
authors: School of Medicine, National Yang-Ming University, Taiwan; Department of Pathology, Taipei Veterans General Hospital, Taiwan.
authors: Wen-Yih
authors: WY
authors: Liang
authors: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan.
authors: Chun-Chi
authors: CC
authors: Lin
authors: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan.
authors: Yuan-Tzu
authors: YT
authors: Lan
authors: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan.
authors: Huann-Sheng
authors: HS
authors: Wang
authors: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan.
authors: Shung-Haur
authors: SH
authors: Yang
authors: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan.
authors: Jeng-Kai
authors: JK
authors: Jiang
authors: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan.
authors: Wei-Shone
authors: WS
authors: Chen
authors: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan.
authors: Tzu-Chen
authors: TC
authors: Lin
authors: Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Section 2. Shih-Pai Road, Taipei 11217, Taiwan; School of Medicine, National Yang-Ming University, Taiwan. Electronic address: changsc@vghtpe.gov.tw.
authors: Shih-Ching
authors: SC
authors: Chang
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000628:therapy*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D002272:Carcinoembryonic Antigen / Q000097:blood*; D059186:Chemoradiotherapy, Adjuvant; D018572:Disease-Free Survival; D019583:Dose Fractionation, Radiation; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D002955:Leucovorin / Q000008:administration & dosage; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011379:Prognosis; D012004:Rectal Neoplasms / Q000097:blood / Q000628:therapy*; D012007:Rectum / Q000601:surgery; D012189:Retrospective Studies; D005641:Tegafur / Q000008:administration & dosage; D016896:Treatment Outcome; D014498:Uracil / Q000008:administration & dosage
chemical_list: D002272:Carcinoembryonic Antigen; D005641:Tegafur; D014498:Uracil; D002955:Leucovorin
keywords: CEA reduction ratio; Carcinoembryonic antigen; Preoperative chemoradiotherapy; Rectal cancer