<p>The prognostic value of the postoperative serum CEA levels/preoperative serum CEA levels ratio in colorectal cancer patients with high preoperative serum CEA levels</p>

Abstract

Purpose This study aimed to assess the prognostic value of the postoperative serum carcinoembryonic antigen (CEA) levels/preoperative serum CEA levels ratio (CEA ratio) in colorectal cancer (CRC) patients with high preoperative serum CEA levels and to identify the optimal prognostic cutoff value. Patients and methods The medical records of 187 CRC patients in a single center who underwent surgery between September 2012 and September 2014 were retrospectively reviewed. CEA ratio was defined as the ratio between the postoperative serum CEA and preoperative serum CEA. The optimal cutoff values for the CEA ratio were determined by time-dependent receiver operating characteristic (ROC) curve analyses. The Chi-square test or Fisher’s exact probability test were used to test the correlation between CEA ratio and clinicopathological characteristics. Univariate, multivariate, and subgroup Cox proportional hazards analysis were used to identify independent prognostic factors. Kaplan–Meier method was used for establishing survival curves. Results The median follow-up time was 62 months (range 3–88 months). The optimal CEA ratio cutoff value closely related to disease-free survival was 0.295. In the Chi-square test, the CEA ratio was associated with pN stage ( p =0.003) and postoperative CEA ( p <0.001). In the multivariate analysis, the CEA ratio was an independent prognostic factor for disease-free survival ( p =0.003, HR 2.300 [95% CI: 1.326–3.988]) and cancer-special survival ( p =0.003, HR 2.525 [95% CI: 1.381–4.614]). The CEA ratio reflected the prognosis of CRC patients more accurately than postoperative CEA levels alone, and the CEA ratio of 0.295 was more likely to reflect the prognosis than other cutoff values. Conclusion The CEA ratio is a simple and useful tool for further forecasting the prognosis of CRC patients with high preoperative CEA levels and may help develop strategies for the postoperative treatment of CRC patients.

The advanced lung cancer inflammation index predicts short and long-term outcomes in patients with colorectal cancer following surgical resection: a retrospective study

“…It is accepted that TNM staging is the most reliable criterion for assessing CRC patient prognosis. However, it has been reported that patients with the same TNM stage often have different prognoses, suggesting that other factors are required for more accurate prognoses (Xie et al, 2019). We conducted a stratified prognostic evaluation based on different TNM stages, and found that survival outcomes of different ALI groups were significantly different in patients with TNM III-IV stage, but there were no differences in patients with TNM I-II stage.…”

Prognostic value of carcinoembryonic antigen levels before and after curative surgery in colon cancer patients

“…Elevated preoperative CEA levels are associated with advanced cancer stage, the incidence of recurrence, and survival. Also, high postoperative CEA levels are associated with residual disease and/or distant metastasis [24,25]. In colon cancer, it is important to predict patient prognosis and detect any early recurrence, thus efforts are being made to identify prognostic factors [22,26,27].…”

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

“…A recent systematic review found that left-sided colon cancer is associated with improved survival [3], suggesting that tumor sidedness could be an important prognostic factor. While postoperative serum carcinoembryonic antigen (CEA) level is routinely used as a marker for possible metastatic disease, the perioperative CEA ratio (post-op/pre-op CEA) may be an important emerging prognostic factor for CRC patients [4,5] and may be especially important in patients with high preoperative CEA levels [6]. To our knowledge, the association between perioperative CEA ratio and tumor location has not been previously established.…”