The Role of Carcinoembryonic Antigen After Neoadjuvant Chemoradiotherapy in Patients With Rectal Cancer

Abstract

Combined pre- and postchemoradiotherapy CEA levels could be useful as a prognostic factor for disease-free survival in patients with rectal cancer who undergo treatment with neoadjuvant chemoradiotherapy and curative resection. Postchemoradiotherapy CEA may be helpful in a selection of patients who want more conservative surgery after chemoradiotherapy.

Clinical utility of pretreatment prediction of chemoradiotherapy response in rectal cancer: a review

“…However, not only the pre-CRT CEA level but also the post-CRT CEA level, and/or the change in the CEA pattern after CRT, are often analyzed together. The latter two measures are more closely related to the pathological CRT response than is the pre-CRT CEA level [58][59][60]. This is not surprising because the latter values reflect the degree of CRT response.…”

Prediction of response to preoperative chemoradiotherapy in patients with locally advanced rectal cancer

“…Perez et al reported that a CEA-post level < 5 ng/mL was associated with increased rates of clinical CR and pCR (37). CEA-post with a different cut-off value of 2.7 ng/mL was also proved to be an independent predictor of good tumor regression (p = 0.001) (38). In a recent study, CEA-post < 2.61 ng/mL also showed a strong predictive value for pCR with a sensitivity of 76.0% and specificity of 58.4% in patients with a low CEA-pre level or in patients with a high CEA-pre level but normalized CEA-post levels (39).…”

“…There is controversy if CEA-pre could be a predictive marker for pCR or not (34)(35)(36)(37)(38)(39). CEA change groups were relevant to pCR, but may not be significant enough (37,38).…”

“…Compared with other potential predictive markers, measurement of serum CEA levels are inexpensive, standardized, widely used and easily performed (33). In recent years, many studies have focused on the predictive value of CEA levels in patients with rectal cancer receiving pre-CRT (Table 3) (34)(35)(36)(37)(38)(39)(40). Most studies showed low pre-CRT CEA (CEA-pre) levels with different cut-off values associated with good tumor response or pCR (34)(35)(36), but concerning the CEA-pre Low CEA-pre was significantly associated with pCR.…”

Pretreatment Serum Cea as a Predictive Biomarker for the Response to Neoadjuvant Chemoradiotherapy: A Meta-Analysis in Rectal Cancer

“…Different cutoff level for CEA was found to be significant for prediction of pCR in several studies. Most studies proposed 5 ng/ml [13][14][15][16][17][18][19][20][21][22][23][24][25][26][27] and others 2.5 ng/ml [9,28], 3 ng/ml [29,30], 3.5 ng/ml [31,32] or 6 ng/ml [22]. Therefore, elevated CEA level was defined as ≥ 5 ng/ml, and normal CEA level refers to <5 ng/ml in current study.…”