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Serum CEA as a predictor for the response to preoperative chemoradiation in rectal cancer

Authors
 Yoon-Ah Park  ;  Seung-Kook Sohn  ;  Jinsil Seong  ;  Seung-Hyuk Baik  ;  Kang-Young Lee  ;  Nam-Kyu Kim  ;  Chang-Whan Cho 
Citation
 JOURNAL OF SURGICAL ONCOLOGY, Vol.93(2) : 145-150, 2006 
Journal Title
 JOURNAL OF SURGICAL ONCOLOGY 
ISSN
 0022-4790 
Issue Date
2006
MeSH
Adenocarcinoma/blood* ; Adenocarcinoma/drug therapy ; Adenocarcinoma/radiotherapy ; Adenocarcinoma/surgery ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Biomarkers, Tumor/blood* ; Carcinoembryonic Antigen/blood* ; Combined Modality Therapy ; Female ; Fluorouracil/administration & dosage ; Humans ; Male ; Middle Aged ; Predictive Value of Tests ; Prognosis ; Rectal Neoplasms/blood* ; Rectal Neoplasms/drug therapy ; Rectal Neoplasms/radiotherapy ; Rectal Neoplasms/surgery ; Survival Rate
Keywords
rectal adenocarcinoma ; preoperative chemoradiation ; serum CEA ; predictor for response
Abstract
BACKGROUND AND OBJECTIVES: Recent data suggest that good responders to preoperative chemoradiation (CRT) have a favorable prognosis in rectal cancer patients. The aim of this study was to investigate the predictive value of serum carcinoembryonic antigen (CEA) levels for the tumor response to preoperative CRT in rectal cancer patients. METHODS: The study comprised 141 rectal adenocarcinoma patients who underwent preoperative radiotherapy with 5-fluorouracil (FU) based chemotherapy, followed by radical surgery. The staging workup was consisted of endorectal ultrasound, abdominopelvic computed tomography scan, or magnetic resonance imaging. The outcome parameters were cancer-specific survival and disease-free survival. Pre-CRT clinicopathologic features, including age, gender, location of the tumor, clinical tumor (cT) classification, clinical nodal (cN) classification, and serum CEA levels were investigated as possible predictors for the response to preoperative CRT. RESULTS: Pathologic complete or near complete responses (good responders, GR) occurred in 26 (19%) patients, while partial or no response (poor responders, PR) occurred in the remaining 115 (81%) patients. GR showed better cancer-specific survival (P = 0.028) and disease-free survival rates (P = 0.011) than PR. Univariate analysis revealed that positive cN and elevated (>5 ng/ml) pre-CRT serum CEA levels are associated with poor tumor response to preoperative CRT. Using logistic regression analysis, elevated pre-CRT serum CEA levels were the only significant predictor for the poor response to CRT (Odd ratio = 2.876, 95% confidence interval = 1.04-7.46, P = 0.041). CONCLUSIONS: Our data suggest that elevated pre-CRT serum CEA levels are associated with poor tumor response to CRT. Therefore, pre-CRT serum CEA levels provide useful information about tumor response to preoperative CRT in rectal cancer patients.
Full Text
http://onlinelibrary.wiley.com/doi/10.1002/jso.20320/abstract
DOI
10.1002/jso.20320
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Baik, Seung Hyuk(백승혁) ORCID logo https://orcid.org/0000-0003-4183-2332
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Sohn, Seung Kook(손승국)
Lee, Kang Young(이강영)
Cho, Chang Hwan(조장환)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/109394
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