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KMID : 0371420160910040165
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Annals of Surgical Treatment and Research
2016 Volume.91 No. 4 p.165 ~ p.171
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The prognostic significance and treatment modality for elevated pre- and postoperative serum CEA in colorectal cancer patients
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Yang Kwan-Mo
Park In-Ja
Kim Chan-Wook
Roh Seon-Ae
Cho Dong-Hyung
Kim Jin-Cheon
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Abstract
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Purpose : The purpose of this study was to evaluate the prognostic significance of serum CEA (s-CEA) changes in colorectal cancer (CRC) patients with sustained elevated postoperative s-CEA levels.
Methods : Between January 1999 and December 2008, 9,380 CRC patients underwent surgery. Curative resection was performed in 1,242 CRC patients with high preoperative s-CEA levels (>6 ng/mL). High s-CEA levels were normalized in 924 patients (74.4%) within 2 weeks from surgery, whereas high s-CEA levels were persistent in 318 patients (25.6%). Patients were divided into 2 groups according to their postoperative s-CEA levels: group 1 (37 patients with a 1-year postoperative s-CEA>6 ng/mL) and group 2 (281 patients with a 1-year postoperative s-CEA≤6 ng/mL).
Results : A postoperative recurrence was identified in 24 patients (64.9%) in group 1 and 65 patients (23.1%) in group 2 (P < 0.001). A curative resection after recurrence was performed in 22 patients (33.8%) from group 2, but no patients from group 1 (P = 0.001). The 5-year overall survival and time to recurrence were significantly lower in patients with recurrent cancer in group 1 (P < 0.001).
Conclusion : Patients with persistent elevated postoperative s-CEA levels are at high risk for recurrence and a low survival rate. More intensive surveillance of patients with high postoperative s-CEA levels should be mandatory.
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KEYWORD
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Serum carcinoembryonic antigens, Colorectal neoplasms, Recurrence, Survival
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