Preoperative serum carcinoembryonic antigen level as a prognostic factor for recurrence after curative resection followed by adjuvant chemotherapy in stage III colon cancer

Abstract

Colorectal cancer is frequently diagnosed and leading cause of cancer death worldwide. Patients with adjuvant chemotherapy gained survival benefit with minimizing recurrence. So it is a necessary to establish more accurate prognostic and prognostic markers for cancer recurrence and survival to improve treatment for individual patients because of considerable diversity and heterogeneity among tissues of the same TNM stage.

Serum carcinoembryonic antigen (CEA) is a 201 kDa highly glycosylated antigen and was demonstrated to be a tumor marker for colon cancer over 45 years ago. With the disruption of normal tissue architecture in malignancy and loss of polarization of neoplastic cells located deep inside the tumor glandular tissue, CEA may expressed on the whole cell surface and is eventually shed into the blood stream leading to a rise in serum CEA levels. So before resection of colon cancer, most guidelines suggest routine measurement of preoperative CEA, mainly for monitoring postoperative surveillance. However, there has been some controversy about the significance of the preoperative CEA level as a prognostic factor of recurrence. Furthermore, few previous reports have considered optimal cutoff values for CEA level.

Here we evaluated the optimal cutoff values for the CEA and whether an elevated preoperative CEA levels represents an independent prognostic factor for recurrence after curative resection of stage III colon cancer. By this study, we strongly recommend routine preoperative CEA measurement in stage III colon cancer patients and inclusion of this result in risk stratifications. Also further large scale studies are necessary to determine a specific valid cutoff values for preoperative CEA level to achieve more accurate prognostic stratifications.