Clinical Significance of Pre- to Post-Chemoradiotherapy s-CEA Reduction Ratio in Rectal Cancer Patients Treated with Preoperative Chemoradiotherapy and Curative Resection

Kim, Chan Wook; Yu, Chang Sik; Yang, Song-Soo; Kim, Kyung Ho; Yoon, Yong Sik; Yoon, Sang Nam; Lim, Seok‐Byung; Kim, Jin Cheon

doi:10.1245/s10434-011-1740-1

Cited by 44 publications

(37 citation statements)

References 22 publications

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“…As for the relations of the serum CEA levels before nCRT and after nCRT to outcomes, several studies have reported that patients with high serum CEA levels before as well as after nCRT have poor outcomes [37][38][39][40]. However, another study has reported that patients with a low rate of decrease in the serum CEA level after nCRT have poor outcomes [41].…”

Section: Discussionmentioning

confidence: 99%

Relations of Changes in Serum Carcinoembryonic Antigen Levels before and after Neoadjuvant Chemoradiotherapy and after Surgery to Histologic Response and Outcomes in Patients with Locally Advanced Rectal Cancer

Saito

Sadahiro²,

Ogimi³

et al. 2017

Oncology

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Objectives: The histologic response to neoadjuvant chemoradiotherapy (nCRT) has been intimately related to outcomes in locally advanced rectal cancer. Serum carcinoembryonic antigen (CEA) levels change after nCRT and after surgery as compared with before nCRT. Methods: The subjects were 149 patients with locally advanced rectal cancer who received nCRT between 2005 and 2013. The patients were divided into 4 groups according to the serum CEA levels: group 1, 55 patients with negative serum CEA levels before nCRT; group 2, 41 patients with positive serum CEA levels before nCRT that became negative after nCRT; group 3, 37 patients with positive serum CEA levels after nCRT that became negative after surgery; and group 4, 16 patients with positive serum CEA levels after nCRT as well as after surgery. Results: Pathological complete response, T downstaging, and tumor shrinkage were significantly higher in group 1 than in other groups. Disease-free survival was significantly poorer in group 4. The lack of a decrease in the serum CEA level in group 4 was most likely attributed to the persistence of micrometastases outside the resection field. Conclusions: Changes in serum CEA levels measured before nCRT, after nCRT, and after surgery can be used to reliably predict the histologic response to nCRT and outcomes.

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Section: Discussionmentioning

confidence: 99%

Relations of Changes in Serum Carcinoembryonic Antigen Levels before and after Neoadjuvant Chemoradiotherapy and after Surgery to Histologic Response and Outcomes in Patients with Locally Advanced Rectal Cancer

Saito

Sadahiro²,

Ogimi³

et al. 2017

Oncology

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“…An increase in CEA levels or persistence of at least 70% from baseline levels has also been suggested as a significant predictor of worse outcome for patients with CEA levels >6 ng/mL at baseline. 35 After neoadjuvant CRT, distinguishing between residual cancer and transmural fibrosis relies on morphologic features like thickening of the rectal wall, densification of the perirectal fat, or presence of small perirectal nodes (< 5 mm). For this reason, CT and endorectal ultrasound are probably best suited for diagnosing residual disease, including mesorectal enlarged nodes or masses.…”

Section: Cea Transrectal Ultrasound Endoscopy and Computed Tomogramentioning

confidence: 99%

Can Surgery be Avoided After Preoperative Chemoradiation for Rectal Cancer in the Era of Organ Preservation? Current Review of Literature

Chawla

Katz

Rauh

et al. 2015

American Journal of Clinical Oncology

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Approximately 10% to 25% of patients have a pathologic complete response after neoadjuvant chemoradiation. There is a compelling argument for attempting to avoid surgery in carefully selected groups of patients. Although nerve-preserving surgical techniques are now standard, the rates of urinary and sexual dysfunction are significant. Also, although sphincter function and quality of life among patients undergoing an ultra-low anterior resection is acceptable, results are poorer than expected and may be disabling. Trials of omission of surgery for selected patients with complete response after preoperative chemoradiation, otherwise known as "Watch and Wait," have shown favorable long-term results. We review the current literature on accepted standards of care and identify areas of controversy and important ongoing clinical studies aiming to resolve these issues.

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“…An increase in CEA levels or persistence of at least 70 % from baseline has been suggested as predictor of worse outcome in patients with CEA levels >6 ng/ml at baseline [ 31 ]. Also, different cutoff values have been considered for patients undergoing CRT when compared to standard colorectal cancer patients.…”

Section: Ceamentioning

confidence: 99%

Selective Non-operative Treatment in Rectal Cancer After Neoadjuvant Chemoradiation: Lessons Learned from the “Watch-and-Wait” Approach

Habr‐Gama¹,

Lynn²,

Perez

2015

Pelvic Cancer Surgery

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Clinical Significance of Pre- to Post-Chemoradiotherapy s-CEA Reduction Ratio in Rectal Cancer Patients Treated with Preoperative Chemoradiotherapy and Curative Resection

Abstract: The reduction ratio of pre- to post-CRT s-CEA concentration may be an independent prognostic factor for disease-free survival following preoperative CRT and surgery in rectal cancer patients with initial s-CEA>6 ng/mL.

Cited by 44 publications

References 22 publications

Relations of Changes in Serum Carcinoembryonic Antigen Levels before and after Neoadjuvant Chemoradiotherapy and after Surgery to Histologic Response and Outcomes in Patients with Locally Advanced Rectal Cancer

Relations of Changes in Serum Carcinoembryonic Antigen Levels before and after Neoadjuvant Chemoradiotherapy and after Surgery to Histologic Response and Outcomes in Patients with Locally Advanced Rectal Cancer

Can Surgery be Avoided After Preoperative Chemoradiation for Rectal Cancer in the Era of Organ Preservation? Current Review of Literature

Selective Non-operative Treatment in Rectal Cancer After Neoadjuvant Chemoradiation: Lessons Learned from the “Watch-and-Wait” Approach

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