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Preoperative Serum Carcinoembryonic Antigen Level as a Prognostic Factor for Recurrence and Survival After Curative Resection Followed by Adjuvant Chemotherapy in Stage III Colon Cancer

 Chang Gon Kim  ;  Joong Bae Ahn  ;  Minkyu Jung  ;  Seung Hoon Beom  ;  Su Jin Heo  ;  Jee Hung Kim  ;  Young Jin Kim  ;  Nam Kyu Kim  ;  Byung Soh Min  ;  Woong Sub Koom  ;  Hoguen Kim  ;  Yun Ho Roh  ;  Bo Gyoung Ma  ;  Sang Joon Shin 
 ANNALS OF SURGICAL ONCOLOGY, Vol.24(1) : 227-235, 2017 
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Adolescent ; Adult ; Aged ; Aged, 80 and over ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use* ; Biomarkers, Tumor/blood ; Carcinoembryonic Antigen/blood* ; Chemotherapy, Adjuvant ; Colonic Neoplasms/drug therapy* ; Colonic Neoplasms/pathology ; Colonic Neoplasms/surgery* ; Female ; Fluorouracil/administration & dosage ; Humans ; Lymph Node Excision ; Male ; Middle Aged ; Neoplasm Recurrence, Local/pathology ; Neoplasm Staging ; Organoplatinum Compounds/administration & dosage ; Prognosis ; Pyrimidines/administration & dosage ; Retrospective Studies ; Treatment Outcome
BACKGROUND: Carcinoembryonic antigen (CEA) is the most widely used tumor marker in colon cancer; however, there has been controversy regarding the significance of preoperative serum CEA level as a prognostic factor for recurrence. In this study, we evaluated the optimal cutoff value and prognostic significance of preoperative serum CEA level in stage III colon cancer. METHODS: Based on a retrospective cohort of 965 patients with stage III colon cancer who underwent elective curative surgery and adjuvant chemotherapy with fluoropyrimidine and oxaliplatin (training set), we determined the optimal cutoff value of CEA for recurrence using the Contal and O'Quigley method. We assessed the prognostic value of this cutoff value in terms of disease-free survival (DFS) and overall survival (OS) in a prospective cohort of 268 patients with stage III colon cancer (validation set). A Cox proportional hazards model was used to explore the association of prognostic variables with DFS and OS. RESULTS: The statistically determined best cutoff value for CEA was 3 ng/mL in the training set. A high CEA level (≥3 ng/mL) was associated with inferior DFS (hazard ratio [HR] 4.609, 95 % confidence interval [CI] 2.028-10.474) and OS (HR 3.956, 95 % CI 1.127-13.882) in the validation set, while multivariate analysis showed that a high CEA level was an independent risk factor for DFS and OS in both study subsets. CONCLUSION: Preoperative serum CEA level is an independent prognostic factor for DFS and OS in patients with stage III colon cancer after curative resection and adjuvant chemotherapy.
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1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
Yonsei Authors
Koom, Woong Sub(금웅섭) ORCID logo https://orcid.org/0000-0002-9435-7750
Kim, Nam Kyu(김남규) ORCID logo https://orcid.org/0000-0003-0639-5632
Kim, Young Jin(김영진)
Kim, Jee Hung(김지형) ORCID logo https://orcid.org/0000-0002-9044-8540
Kim, Ho Keun(김호근)
Min, Byung Soh(민병소) ORCID logo https://orcid.org/0000-0003-0180-8565
Beom, Seung Hoon(범승훈) ORCID logo https://orcid.org/0000-0001-7036-3753
Shin, Sang Joon(신상준) ORCID logo https://orcid.org/0000-0001-5350-7241
Ahn, Joong Bae(안중배) ORCID logo https://orcid.org/0000-0001-6787-1503
Jung, Min Kyu(정민규) ORCID logo https://orcid.org/0000-0001-8281-3387
Heo, Su Jin(허수진) ORCID logo https://orcid.org/0000-0002-0615-5869
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