The predictive value of preoperative carcinoembryonic antigen level in the prognosis of colon cancer.

Abstract

BACKGROUND:

We evaluated factors associated with an increased preoperative carcinoembryonic antigen (CEA) level for colon cancer patients undergoing elective curative surgery and assessed whether this was associated with prognosis when accounting for other potential confounders.

METHODS:

Prospectively accrued data of patients with stage I, II, and III colon cancer undergoing surgery (1980-2008) were retrieved retrospectively. Patients with a preoperative CEA level greater than 5 ng/mL (group B) were compared with those with a CEA level of 5 ng/mL or less (group A).

RESULTS:

There were 651 patients (379 men) with a median age of 67 years (range, 21-94 y) and a median follow-up period of 5.9 years. Groups A (n = 451) and B (n = 200) had similar ages and tumor locations. Group B had larger tumors; more patients with T3 and N1/N2; and more patients with stage II/III tumors, and hence greater use of chemotherapy (P = .04). On multivariate analysis, patient age, tumor stage, and differentiation were associated with oncologic outcomes. A CEA level greater than 5 ng/mL was not associated independently with recurrence, recurrence-free survival (P = .47), or overall survival (P = .3).

CONCLUSIONS:

An increased preoperative CEA level is a marker for a more advanced tumor stage. For adequately staged patients, a high preoperative CEA level is not associated independently with oncologic outcomes.

• Authors: Hasan T Kirat, Ersin Ozturk, Ian C Lavery, Ravi P Kiran
• Journal: American journal of surgery (Am J Surg) Vol. 204 Issue 4 Pg. 447-52 (Oct 2012) ISSN: 1879-1883 [Electronic] United States
• PMID: 22481066 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Biomarkers, Tumor
• Carcinoembryonic Antigen

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor (blood)
• Carcinoembryonic Antigen (blood)
• Colectomy
• Colonic Neoplasms (immunology, pathology, surgery)
• Disease-Free Survival
• Elective Surgical Procedures
• Female
• Humans
• Male
• Middle Aged
• Multivariate Analysis
• Neoplasm Staging
• Predictive Value of Tests
• Preoperative Period
• Prognosis
• Retrospective Studies
• Treatment Outcome