Prognostic impact of CEA levels in rectal cancer patients who had received neoadjuvant chemoradiotherapy

Abstract

Carcinoembryonic antigen (CEA) is a useful marker for rectal cancer. The aim of this study was to investigate the prognostic impact of CEA level according to neoadjuvant chemoradiotherapy (nCRT) in rectal cancer patients who underwent radical surgery.Methods: A total of 245 patients with rectal cancer who underwent radical surgery were retrospectively evaluated. Serum CEA level was measured preoperatively and postoperatively. We compared survival outcomes based on CEA level before and after surgery according to nCRT.Results: Of the 245 patients, elevation of CEA level was observed preoperatively in 79 and postoperatively in 30, respectively. Eighty-seven (35.5%) patients received nCRT, and elevated CEA level was a significant prognostic factor both before and after surgery. In patients who had not received nCRT, an elevated CEA level was a significant prognostic factor before surgery but was not significant after surgery. In a multivariate analysis for prognostic factors, elevation of preoperative CEA level was an independent prognostic factor of disease-free survival (DFS) regardless of nCRT.Postoperative CEA level was an independent prognostic factor of DFS in patients who had received nCRT but was not a factor in patients who had not received nCRT. Conclusion:Serum CEA level was an independent prognostic factor both preoperatively and postoperatively in rectal cancer patients who had received nCRT.

Prognostic Impact of An Integrative Landscape of Clinical, Immune, and Molecular Features in Non-Metastatic Rectal Cancer

“…Several clinicopathological and molecular features has been associated with a prognostic and/or predictive value in RC such us the mucinous histology (21,22), the unresponsiveness associated with mismatch repair-deficient tumors (23), loss of CDX2 expression (24), elevated pretreatment CEA levels (25), high serum inflammation markers (26,27), and the association between a low CD3 and CD8 tumor-infiltrating lymphocytes density in the pretreatment biopsies and minimal regression to CRT (28). Tumor tissue-based molecular predictors of response to nCRT in LARC patients have been extensively studied.…”

Carcinoembryonic Antigen, the Most Accessible Test for Predicting Colorectal Cancer Prognosis: Exploring Alternative Roles

“…The present study suggests that CEA plays a particularly meaningful role in predicting prognosis after nCRT in patients with rectal cancer [ 6 ]. As discussed in the limitations of the present study, it is unfortunate that the relationship between tumor response after nCRT and CEA level could not be studied.…”