title: [Prognostic value of preoperative carcinoembryogenic antigen: Is it useful in all stages of colorectal cancer?].
abstract: BACKGROUND
  Recent reports have reopened discussion of the prognostic value of elevated pre-treatment carcinoembryonic antigen (CEA) levels in colorectal cancer. Due to the discrepancies in the published results, we aimed to analyze the possible predictive value of CEA, both overall and in different tumoral stages in our environment.
  
  
  METHODS
  We retrospectively studied 303 consecutive patients with colorectal cancer resected with curative intent by analysing tumor-related mortality. The frequency of patients with increased CEA levels (> 5mg/l) was registered. Univariate and multivariate analyses of survival curves were performed, comparing patients with increased CEA levels and those with CEA levels within normal limits, both in the overall series and in the different pTNM tumoral stages.
  
  
  RESULTS
  Frequency of patients with CEA>5mg/l was 31%. The median clinical follow-up was 83 months. A poor survival rate was registered in the multivariate analysis of the whole series in patients with high CEA levels: hazard ratio (HR)=1.81; 95% confidence interval (95% CI)=(1.15-3.10); P=.012. This predictive value was only maintained in stage II in the survival analysis of the distinct tumoral stages (n=104): HR=3.02; 95% CI=(1.22-7.45); P=.017.
  
  
  CONCLUSIONS
  Before treatment, 31% of our patients with colorectal cancer resected with curative intent had pathological CEA values. In the overall series, a high pretreatment CEA level showed an independent prognostic value for poor survival. When pTNM tumoral stages were analyzed separately, CEA level had predictive value only in pTNM II tumors.
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, España. Electronic address: bordafernando@yahoo.es.
authors.forename: Ana
authors.initials: A
authors.lastname: Borda
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, España.
authors.forename: Carlos
authors.initials: C
authors.lastname: Prieto
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, España.
authors.forename: Javier
authors.initials: J
authors.lastname: Jiménez
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, España.
authors.forename: Juan
authors.initials: J
authors.lastname: Vila
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, España.
authors.forename: José Manuel
authors.initials: JM
authors.lastname: Zozaya
authors.affiliation: Servicio de Digestivo, Complejo Hospitalario de Navarra, Instituto de Investigaciones Sanitarias de Navarra (IDISNA), Pamplona, España.
authors.forename: Fernando
authors.initials: F
authors.lastname: Borda
mesh_terms: D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D006801:Humans; D011379:Prognosis; D015996:Survival Rate
chemical_list: D002272:Carcinoembryonic Antigen
keywords: Antígeno carcinoembrionario; Carcinoembryogenic antigen; Colorectal cancer; Cáncer colorrectal; Estadio tumoral pTNM; Prognosis; Pronóstico; pTNM tumoral stage