Association between Primary Perioperative CEA Ratio, Tumor Site, and Overall Survival in Patients with Colorectal Cancer

Abstract

There are differences in the incidence, clinical presentation, molecular pathogenesis, and outcome of colorectal cancer (CRC) based on tumor location. Emerging research suggests that the perioperative carcinoembryonic antigen (CEA) ratio (post-op/pre-op CEA) is a prognostic factor for CRC patients. We aimed to determine the association between CEA ratio, tumor location, and overall survival (OS) among patients with CRC. We analyzed 427 patients who underwent resection for CRC at the University of Kansas Medical Center. After excluding those without pre- or post-operative CEA data, 207 patients were classified as either high (≥0.5) or low (<0.5) ratio. Primary outcomes were as follows: (1) OS stratified by CEA ratio; (2) OS stratified by tumor location; (3) OS stratified by tumor location among those with CEA elevation > 5 ng/mL at the time of recurrence. The Kaplan–Meier method was used to estimate survival rates. The median age was 62 years (inter-quartile range 51–71), 55% were male, 41% were smokers, 71% had left-sided tumors, the median pre-operative CEA was 3.1 ng/mL (inter-quartile range (IQR) 1.5–9.7), and 57% had a CEA ratio ≥0.5. The OS rates were 65.1% and 86.3% in patients with high versus low CEA ratios, respectively (log-rank p-value = 0.045). The OS rates were 64.4% and 77.3% in patients with right-sided vs. left-sided tumors, respectively (log-rank p-value = 0.5). Among patients with CEA levels greater than 5 at the time of recurrence, the OS rates were 42.9% and 43.4% in patients with right-sided vs. left-sided tumors, respectively (log-rank p-value = 0.7). There was a significantly higher survival among patients with low CEA ratios than among those with high CEA ratios. There was no difference in OS between left- versus right-sided tumors. Among patients with CEA elevation > 5 ng/mL at the time of recurrence, there was no difference in OS between left versus right-sided tumors. These findings warrant validation in a larger cohort as our sample size was limited.

Comparison of Resected Malignant Tumors of the Right- and Left-Sided Colon—Is There a Difference?

“…According to the data of 414 patients, the OS and diseasefree survival (DFS) was found to be lower in RCC patients compared to LCC [15]. Similarly to our results, a study with 427 patients found no difference in OS comparing the rightand left-sided colorectal cancer, and there was a significantly higher OS among patients with low CEA values [16]. In a study published in 2020, the authors also did not observe differences in overall, disease-specific, or relative survival in patients with RCC versus LCC [17].…”

Both In Situ and Circulating SLC3A2 Could Be Used as Prognostic Markers for Human Lung Squamous Cell Carcinoma and Lung Adenocarcinoma

“…Serum proteins have been used as diagnostic and prognostic markers for cancers for more than thirty years [ 20 ]. As an auxiliary means, serum protein improves the accuracy of diagnosis, such as CEA for colorectal cancer [ 21 ]. However, to our knowledge, no previous studies have shown the diagnostic or prognostic roles of serum SLC3A2 in lung cancer.…”

A Label-Free Electrochemical Immunosensor for CEA Detection on a Novel Signal Amplification Platform of Cu2S/Pd/CuO Nanocomposites

“…Colorectal cancer morbidity ranks third among malignancies, but second in terms of mortality (Sung et al, 2021). Carcinoembryonic antigen (CEA) is used as an important indicator for the diagnosis, treatment, recurrence, and metastasis of CRC (Konishi et al, 2018;Odeny et al, 2020). Additionally, CEA was also associated with other tumors, such as lung cancer (Grunnet and Sorensen, 2012), breast cancer (Tang et al, 2016), and pancreatic cancer (Xing et al, 2018).…”