scholarly journals Association Between Serum Carcinoembryonic Antigen Levels at Different Perioperative Time Points and Colorectal Cancer Outcomes

2021 ◽  
Vol 11 ◽  
Author(s):  
Zhenhui Li ◽  
Dafu Zhang ◽  
Xiaolin Pang ◽  
Shan Yan ◽  
Ming Lei ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Sensitivity Analysis ◽  
Carcinoembryonic Antigen ◽  
Cox Regression ◽  
Neoadjuvant Treatment ◽  
Stage Ii ◽  
Optimal Timing ◽  
Primary Analysis ◽  
Serum Carcinoembryonic Antigen ◽  
Serum Cea

BackgroundWhether elevated postoperative serum carcinoembryonic antigen (CEA) levels are prognostic in patients with stage II colorectal cancer (CRC) remains controversial.Patients and MethodsPrimary and sensitivity analysis populations were obtained from a retrospective, multicenter longitudinal cohort including consecutive patients without neoadjuvant treatment undergoing curative resection for stage I–III CRC. Serum CEA levels before (CEApre-m1) and within 1 (CEApost-m1), 2–3 (CEApost-m2–3), and 4–6 months (CEApost-m4–6) after surgery were obtained, and their associations with recurrence-free survival (RFS) and overall survival (OS) were assessed using Cox regression. Sensitivity and subgroup analyses were performed.ResultsPrimary and sensitivity analysis populations included 710 [415 men; age, 54.8 (11.6) years] and 1556 patients [941 men; age, 56.2 (11.8) years], respectively. Recurrence hazard ratios (HRs) in the elevated CEApre-m1, CEApost-m1, CEApost-m2–3, and CEApost-m4–6 groups were 1.30 (95% CI: 0.91–1.85), 1.53 (95% CI: 0.89–2.62), 1.88 (95% CI: 1.08–3.28), and 1.15 (95% CI: 0.91–1.85), respectively. The HRs of the elevated CEApre-m1, CEApost-m1, CEApost-m2–3, and CEApost-m4–6 groups for OS were 1.09 (95% CI: 0.60–1.97), 2.78 (95% CI: 1.34–5.79), 2.81 (95% CI: 1.25–6.30), and 3.30 (95% CI: 1.67–.536), respectively. Adjusted multivariate analyses showed that both in the primary and sensitivity analysis populations, elevated CEApost-m2–3, rather than CEApre-m1, CEApost-m1, and CEApost-m4–6, was an independent risk factor for recurrence, but not for OS. The RFS in the elevated and normal CEApost-m2–3 groups differed significantly among patients with stage II disease [n = 266; HR, 2.89; 95% CI, 1.02–8.24 (primary analysis); n = 612; HR, 2.69; 95% CI, 1.34–5.38 (sensitivity analysis)].ConclusionsElevated postoperative CEA levels are prognostic in patients with stage II CRC, with 2–3 months after surgery being the optimal timing for CEA measurement.

scholarly journals Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA

2022 ◽  
Vol 11 ◽  
Author(s):  
Du Fenqi ◽  
Liu Yupeng ◽  
Zhang Qiuju ◽  
Yuan Chao ◽  
Song Wenjie ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Sensitivity Analysis ◽  
Cox Regression ◽  
Roc Curves ◽  
Stage Ii ◽  
P Values ◽  
Cutoff Value ◽  
Absolute Value ◽  
Serum Carcinoembryonic Antigen ◽  
Before And After

BackgroundSerum carcinoembryonic antigen (CEA) is an important biomarker for diagnosis, prognosis, recurrence, metastasis monitoring, and the evaluation of the effect of chemotherapy in colorectal cancer (CRC). However, few studies have focused on the role of early postoperative CEA in the prognosis of stage II CRC.MethodsPatients with stage II CRC diagnosed between January 2007 and December 2015 were included. Receiver operating characteristic (ROC) curves were used to obtain the cutoff value of early postoperative CEA, CEA ratio and CEA absolute value. The areas under curves (AUCs) were used to estimate the predictive abilities of the CEA and T stage. The stepwise regression method was used to screen the factors included in the Cox regression analysis. Before and after propensity score (PS) - adjusted Cox regression and sensitivity analysis were used to identify the relationship between early postoperative CEA and prognosis. Meta-analysis was performed to verify the results. Kaplan-Meier survival curves were used to estimate the effects of CEA on prognosis.ResultsWe included 1081 eligible patients. ROC curves suggested that the cutoff value of early postoperative CEA was 3.66 ng/ml (P <0.001) and the AUC showed early postoperative CEA was the most significant prognostic marker in stage II CRC (P = 0.0189). The Cox regression and sensitivity analysis before and after adjusting for PS both revealed elevated early postoperative CEA was the strongest independent prognostic factor of OS, DFS, and CSS (P < 0.001). Survival analysis revealed that patients with elevated early postoperative CEA had lower OS (53.62% VS 84.16%), DFS (50.03% VS 86.75%), and CSS (61.77% VS 90.30%) than patients with normal early postoperative CEA (P < 0.001). When the postoperative CEA was positive, the preoperative CEA level showed no significant effect on the patient’s prognosis (all P-values were > 0.05). Patients with a CEA ratio ≤0.55 or CEA absolute value ≤-0.98 had a worse prognosis (all P-values were < 0.001). Survival analysis suggested that adjuvant chemotherapy for stage II CRC patients with elevated early postoperative CEA may improve the CSS (P = 0.040).ConclusionsEarly postoperative CEA was a better biomarker for prognosis of stage II CRC patients than T stage and preoperative CEA, and has the potential to become a high-risk factor to guide the prognosis and treatment of stage II CRC patients.

scholarly journals Hubungan Nilai Carcinoembryonic Antigen dengan Derajat Diferensiasi pada Karsinoma Kolorektal di RSUP Prof. Dr. R. D. Kandou Manado

2018 ◽  
Vol 10 (2) ◽  
Author(s):  
John Wesley ◽  
Toar Mambu ◽  
Heber Sapan ◽  
Winfried M. Sumanti
Keyword(s):  
Colorectal Cancer ◽  
Carcinoembryonic Antigen ◽  
Cancer Patients ◽  
Correlation Study ◽  
North Sulawesi ◽  
Preoperative Serum ◽  
Serum Carcinoembryonic Antigen ◽  
Serum Cea ◽  
Differentiation Stage ◽  
Colorectal Cancer Patients

Abstract: Colorectal cancer is a serious health problem in Indonesia as well as in North Sulawesi. Serum carcinoembryonic antigen (CEA) is a progmostic factor in patients with this disease. This study was aimed to obtain the correlation between the histopathological differentiation stage and serum CEA level in colorectal cancer patients at Prof. Dr. R. D. Kandou Hospital Manado. This was an analytical correlation study. Subjects were colorectal cancer patients who had preoperative serum CEA level and histopathological differentiation stage results. Data were analyzed with Anova test (variant analysis) and Spearman Rho test. The results showed that there were 58 colorectal cancer patients enrolled in this study. The patients’ data were obtained from the Digestive Surgery clinic and nursery room of Prof. Dr. R. D. Kandou Hospital Manado. Of the 58 patients, 37 (63.79%) had moderate differentiated colorectal cancer. Related to serum CEA level, 23 patients (39.65%) had moderate differentiated colorectal cancer with serum CEA level 20-100 ng/ml. The Spearman Rho test showed that there was a positive correlation between serum CEA level and histopathoplogical differentiation stage of cancer (r = 0.877 and P = 0.001). Conclusion: There was a significant correlation between serum CEA level and histopathological differentiation stage of colorectal cancer. The better the differentiation stage, the higher the serum CEA level.Keywords: carcinoembryonic antigen, colorectal cancer, differentiation stageAbstrak: Karsinoma kolorektal (KKR) telah menjadi masalah kesehatan yang serius di Indonesia dan Sulawesi Utara pada khususnya. Kadar carcinoembryonic antigen (CEA) merupakan salah satu faktor prognostik pada penderita KKR. Penelitian ini bertujuan untuk mengetahui hubungan antara derajat diferensiasi histopatologik dengan kadar CEA dalam serum pada pasien KKR di RSUP Prof. Dr. R. D. Kandou Manado. Jenis penelitian ini ialah analitik korelatif. Subyek penelitian ialah 58 pasien KKR yang mempunyai hasil pemeriksaan kadar CEA serum preoperasi dan pemeriksaan derajat diferensiasi histopatologik. Analisis statistik menggunakan uji Anova (analisis variansi) dan korelasi Spearman Rho. Data pasien diambil dari pasien yang datang dan kontrol di Poliklinik Bedah Digestif serta dari ruang perawatan Bedah Digestif RSUP Prof. Dr. R. D. Kandou Manado. Hasil penelitian memperlihatkan derajat diferensiasi tumor kolorektal terbanyak ialah diferensiasi sedang/moderate differentiated yaitu 37 pasien (63,79%). Bila dihubungkan dengan nilai CEA serum, yang terbanyak ditemukan ialah jenis diferensiasi sedang pada pasien dengan kadar CEA serum 20-100 ng/ml sebanyak 23 orang (39,65%). Uji Spearman Rho memperlihatkan bahwa kadar CEA berkorelasi positif dengan derajat diferensiasi KKR (r = 0,877 dan P = 0,0001). Simpulan: Terdapat korelasi bermakna antara kadar CEA serum dan derajat diferensiasi kanker kolorektal. Derajat diferensiasi KKR yang baik memiliki kadar CEA yang tinggi.Kata kunci: carcinoembryonic antigen, karsinoma kolorektal, derajat differensiasi

Association of postoperative serum carcinoembryonic antigen (CEA) with disease-free survival in patients with stage III colon cancer: ACHIEVE phase III randomized clinical trial.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 4069-4069
Author(s):  
Masahito Kotaka ◽  
Dai Manaka ◽  
Tetsuya Eto ◽  
Junichi Hasegawa ◽  
Akinori Takagane ◽  
...  
Keyword(s):  
Clinical Trial ◽  
Colon Cancer ◽  
Carcinoembryonic Antigen ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Free Survival ◽  
Cutoff Values ◽  
Serum Carcinoembryonic Antigen ◽  
Serum Cea ◽  
Disease Free

4069 Background: ACHIEVE, as part of the IDEA collaboration, was a multicenter trial randomizing patients with stage 3 resected colon cancer to either 3 versus 6 months of adjuvant FOLFOX/CAPOX. We previously reported that the hazard ratios (HRs) in disease-free survival (DFS) of 3 versus 6 months duration according to risk stage (low-risk [T1-3 and N1] or high-risk [T4 or N2]) and regimen (FOLFOX or CAPOX) as well as in overall population were consistent with those observed in the whole IDEA. This study aimed to clarify the significance of post-operative serum carcinoembryonic antigen (CEA) on DFS in stage 3 colon cancer. Methods: Eligibility included post-operative serum CEA value of ≤10 ng/ml at registration in the ACHIEVE trial, which enrolled 1313 patients between 2012 and 2014, out of whom 1291 pts were the modified ITT (mITT) population and used in this study. The cutoff values of CEA analyzed for prognostic analyses were the median value (1.8 ng/ml) in the mITT, the upper limit of normal (ULN) level (5.0 ng/ml), and the half of ULN (2.5 ng/ml). The association of post-operative CEA with DFS were measured by Cox regression analyses. Results: Of the 3 cutoff values, the ULN (5.0 ng/ml) was associated with DFS more strongly than the median (1.8 ng/ml) or half of ULN (2.5 ng/ml), with a HR of 1.75 (95%CI, 1.24-2.46) (Table). The 99 patients (7.7%) were identified as the CEA > ULN and 1192 (92.3%) as < ULN. In univariate analysis, regimen (CAPOX or FOLFOX), ECOG PS (0 or 1), T factor (T1-3 or T4), N factor (N1 or N2-3) and CEA ( < ULN or > ULN) were significantly associated with DFS. Multivariate Cox regression identified CEA > ULN as an independent poor risk factor (HR = 1.45; 95%CI, 1.03-2.05). Shorter DFS in patients with CEA > ULN than in those with CEA < ULN was consistently observed in each subgroup of baseline factors, including treatment duration, regimen, age, gender, PS, T-stage, N-stage, no of lymph nodes examined, and tumor location; no interaction was observed between CEA and these factors. Conclusions: Post-operative serum CEA is also a strong prognostic factor for DFS in stage 3 colon cancer. Clinical trial information: 000008543 . [Table: see text]

scholarly journals Clinical Significance of Serum Carcinoembryonic Antigen and Carbohydrate Antigen 19-9 Levels Before Surgery and During Postoperative Follow-Up in Colorectal Cancer

2018 ◽  
Vol 103 (7-8) ◽  
pp. 322-330
Author(s):  
Harunobu Sato ◽  
Yoshikazu Koide ◽  
Miho Shiota ◽  
Hiroshi Takahashi ◽  
Zenichi Morise ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Carcinoembryonic Antigen ◽  
Disease Free Survival ◽  
Carbohydrate Antigen ◽  
Preoperative Serum ◽  
Serum Carcinoembryonic Antigen ◽  
Group A ◽  
Serum Cea ◽  
Group B

Objective: Carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are the most common colorectal cancer markers. We aimed to identify the appropriate clinical conditions for measuring serum CEA and CA19-9 levels before surgery and during follow-up. Methods: This study included 1275 colorectal cancer patients who were divided into 3 groups according to preoperative CEA levels (group A, ≤5 ng/mL; group B, &gt;5–≤11 ng/mL; group C, &gt;11 ng/mL). Each group was subdivided into 2 groups according to preoperative CA19-9 levels (cutoff level: ≤37 U/mL). Recurrence and survival rates were analyzed. Results: Recurrence rate, disease-free survival after curative surgery, and prognosis were significantly worse in group A and B patients with high CA19-9 levels. At recurrence, CEA levels showed a greater increase in group B and C patients; CA19-9 levels increased in group A patients with high CA19-9 levels. At recurrence, high serum CA19-9 levels were observed in group A patients with high preoperative serum CA19-9 levels, even if the serum CEA level did not increase. Preoperative CA19-9 levels could predict recurrence and prognosis in groups A and B. Conclusion: Periodic CA19-9 determination is useful for monitoring recurrence among group A patients with high CA19-9 levels.

Prognostic role of aberrant mTOR activation in patients with stage II and III colorectal cancer

2020 ◽  
Vol 14 (12) ◽  
pp. 1127-1137
Author(s):  
Tong-Tong Zhang ◽  
Yi-Qing Zhu ◽  
Hong-Qing Cai ◽  
Jun-Wen Zheng ◽  
Jia-Jie Hao ◽  
...  
Keyword(s):  
Colorectal Cancer ◽  
Cox Regression ◽  
Disease Free Survival ◽  
Stage Ii ◽  
Poor Prognostic Factor ◽  
Cox Regression Analysis ◽  
Kaplan Meier ◽  
Potential Biomarker ◽  
Risk Predictor

Aim: This study aimed to develop an effective risk predictor for patients with stage II and III colorectal cancer (CRC). Materials & methods: The prognostic value of p-mTOR (Ser2448) levels was analyzed using Kaplan–Meier survival analysis and Cox regression analysis. Results: The levels of p-mTOR were increased in CRC specimens and significantly correlated with poor prognosis in patients with stage II and III CRC. Notably, the p-mTOR level was an independent poor prognostic factor for disease-free survival and overall survival in stage II CRC. Conclusion: Aberrant mTOR activation was significantly associated with the risk of recurrence or death in patients with stage II and III CRC, thus this activated proteins that may serve as a potential biomarker for high-risk CRC.

Sign in / Sign up

Export Citation Format

Share Document