Prognostic impact of CEA levels in rectal cancer patients who had received neoadjuvant chemoradiotherapy

• Published in: Annals of coloproctology pp. 179 - 185
• Main Authors: Joo, Jung Il, Lim, Sang Woo, Oh, Bo Young
• Format: Journal Article
• Language: English
• Published: Korea (South) 대한대장항문학회 01.06.2021
• Subjects: 일반외과학; neoadjuvant chemoradiotherapy; carcinoembryonic antigen; oncologic outcome; rectal cancer
• ISSN: 2287-9714; 2287-9722
• DOI: 10.3393/ac.2020.11.27

Carcinoembryonic antigen (CEA) is a useful marker for rectal cancer. The aim of this study was to investigate the prognostic impact of CEA level according to neoadjuvant chemoradiotherapy (nCRT) in rectal cancer patients who underwent radical surgery. A total of 245 patients with rectal cancer who underwent radical surgery were retrospectively evaluated. Serum CEA level was measured preoperatively and postoperatively. We compared survival outcomes based on CEA level before and after surgery according to nCRT. Of the 245 patients, elevation of CEA level was observed preoperatively in 79 and postoperatively in 30, respectively. Eighty-seven (35.5%) patients received nCRT, and elevated CEA level was a significant prognostic factor both before and after surgery. In patients who had not received nCRT, an elevated CEA level was a significant prognostic factor before surgery but was not significant after surgery. In a multivariate analysis for prognostic factors, elevation of preoperative CEA level was an independent prognostic factor of disease-free survival (DFS) regardless of nCRT. Postoperative CEA level was an independent prognostic factor of DFS in patients who had received nCRT but was not a factor in patients who had not received nCRT. Serum CEA level was an independent prognostic factor both preoperatively and postoperatively in rectal cancer patients who had received nCRT.