Monitoring of Serum Carcinoembryonic Antigen Levels after Curative Resection of Colon Cancer: Cutoff Values Determined according to Preoperative Levels Enhance the Diagnostic Accuracy for Recurrence.

Abstract

OBJECTIVES:

Serum carcinoembryonic antigen (CEA) has been widely used for postoperative surveillance for colorectal cancer. However, serum CEA has a poor diagnostic accuracy for detecting recurrence. We tested the hypothesis that determining cutoff values according to the preoperative serum CEA levels would enhance the diagnostic accuracy.

METHODS:

Serum CEA was measured before and 1-6 months after surgery in 783 patients with curatively resected colon cancer from 2005 through 2013. The cutoff values during surveillance were determined separately according to preoperative serum CEA levels.

RESULTS:

In patients with negative preoperative serum CEA, the diagnostic accuracy for recurrence was 89.1% when a postoperative cutoff value was set at 5 ng/mL. However, in patients with positive preoperative serum CEA, the diagnostic accuracy was 58.4% when a postoperative cutoff value was set at 5 ng/mL, and was 75.6% when a cutoff value was set at 8 ng/mL. Among patients with positive preoperative serum CEA, the recurrence-free survival rate was significantly lower in patients with a serum CEA of ≥8 ng/mL than those with a serum CEA of <8 ng/mL (p = 0.0018).

CONCLUSIONS:

The diagnostic accuracy of serum CEA for recurrence is enhanced by separately setting cutoff values according to preoperative serum CEA.

• Authors: Gota Saito, Sotaro Sadahiro, Hiroko Kamata, Hiroshi Miyakita, Kazutake Okada, Akira Tanaka, Toshiyuki Suzuki
• Journal: Oncology (Oncology) Vol. 92 Issue 5 Pg. 276-282 ( 2017) ISSN: 1423-0232 [Electronic] Switzerland
• PMID: 28178692 (Publication Type: Journal Article)
• Copyright: © 2017 The Author(s) Published by S. Karger AG, Basel.

Chemical References

• Biomarkers, Tumor
• Carcinoembryonic Antigen

Topics

• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor (blood)
• Carcinoembryonic Antigen (blood)
• Colonic Neoplasms (blood, diagnosis, pathology, surgery)
• Female
• Follow-Up Studies
• Humans
• Japan
• Male
• Middle Aged
• Neoplasm Recurrence, Local (blood, diagnosis)
• Predictive Value of Tests
• Preoperative Care
• Prognosis