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KMID : 0356720130290030115
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Journal of the Korean Society of Coloproctology
2013 Volume.29 No. 3 p.115 ~ p.122
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Prognostic Significance of the Decreased Rate of Perioperative Serum Carcinoembryonic Antigen Level in the Patients With Colon Cancer After a Curative Resection
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Jung Tae-Doo
Yoo Jong-Han
Lee Min-Jae
Park Ha-Kyung
Shin Jae-Ho
An Min-Sung
Ha Tae-Kwun
Kim Kwang-Hee
Bae Ki-Beom
Kim Tae-Hyeon
Choi Chang-Soo
Hong Kwan-Hee
Oh Min-Kyung
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Abstract
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Purpose: The serum level of carcinoembryonic antigen (CEA) is a clinical prognostic factor in the follow-up evaluation of patients with colon cancer. We aimed to evaluate the prognostic significance of the rate of decrease of the perioperative serum CEA level in patients with colon cancer after a curative resection.
Methods: A total of 605 patients who underwent a curative resection for colon cancer between January 2000 and December 2007 were enrolled retrospectively. The rate of decrease was calculated using the following equation: ([preoperative CEA - postoperative CEA]/[preoperative CEA] ×100).
Results: In the group with a preoperative serum CEA level of >5 ng/mL, the normalized group with a postoperative serum CEA level of ≤5 ng/mL showed a better overall survival (OS) rate and disease-free survival (DFS) rate than those of the non-normalized group (P ≤ 0.0001). The "cutoff values" of the rate of decrease in the perioperative serum CEA that determined the OS and the DFS were 48.9% and 50.8%, respectively. In the multivariate analysis of preoperative serum CEA levels >5 ng/mL, the prognostic factors for the OS and the DFS were the cutoff value (P < 0.0001) and the pN stage (P < 0.0001).
Conclusion: A rate of decrease of more than 50% in the perioperative serum CEA level, as well as the normalization of the postoperative serum CEA level, may be useful factors for determining a prognosis for colon cancer patients with high preoperative CEA levels.
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KEYWORD
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Colon neoplasms, Carcinoembryonic antigen, Prognostic factor
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