Preoperative Carcinoembryonic Antigen and Prognosis of Colorectal Cancer. An Independent Prognostic Factor Still Reliable

Abstract

To evaluate whether, in a sample of patients radically treated for colorectal carcinoma, the preoperative determination of the carcinoembryonic antigen (p-CEA) may have a prognostic value and constitute an independent risk factor in relation to disease-free survival. The preoperative CEA seems to be related both to the staging of colorectal neoplasia and to the patient's prognosis, although this-to date-has not been conclusively demonstrated and is still a matter of intense debate in the scientific community. This is a retrospective analysis of prospectively collected data. A total of 395 patients were radically treated for colorectal carcinoma. The preoperative CEA was statistically compared with the 2010 American Joint Committee on Cancer (AJCC) staging, the T and N parameters, and grading. All parameters recorded in our database were tested for an association with disease-free survival (DFS). Only factors significantly associated (P , 0.05) with the DFS were used to build multivariate stepwise forward logistic regression models to establish their independent predictors. A statistically significant relationship was found between p-CEA and tumor staging (P , 0.001), T (P , 0.001) and N parameters (P ¼ 0.006). In a multivariate analysis, the independent prognostic factors found were: p-CEA, stages N1 and N2 according to AJCC, and G3 grading (grade). A statistically significant difference (P , 0.001) was evident between the DFS of patients with normal and high p-CEA levels. Preoperative CEA makes a preoperative selection possible of those patients for whom it is likely to be able to predict a more advanced staging.

Characteristics of colorectal cancer diagnosed with screening abdominal ultrasonography

“…Our results demonstrated that the CEA and CA 19-9 levels were higher compared with the normal values. CEA correlates with disease-free survival after surgery for CRC (23). These results and previous reports suggest that CRC diagnosed with abdominal US is advanced.…”

Novel biomarkers for the diagnosis and prognosis of colorectal cancer

“…Many studies have supported the prognostic value of preoperative CEA levels. 133 Park et al 134 analyzed 2,230 CRC patients and found that CEA level was significantly associated with patient outcomes. According to 2 large-scale case studies, preoperative CEA level was significantly associated with prognosis in patients with CRC that metastasized to the liver.…”

Pre‐operative carcinoembryonic antigen predicts survival following colorectal cancer surgery with curative intent

“…This is in contrast to larger studies including that of Destri et al . who studied 395 patients with colorectal cancer and found that a pre‐operative CEA above 5 ng/mL was associated with a significantly increased risk of recurrence (OR 1.02, P = 0.004) . Patients in the present study dying from undetected recurrent disease may explain the difference in DFS between high and low CEA patients and would require autopsy data to explore this further.…”