Utility of carcinoembryonic antigen (CEA) in appendiceal carcinoma

Karippot, Asha; Groover, Sarah; Ai, Jizhou; Nambiar, Sudheer

doi:10.1093/annonc/mdy281.128

Cited by 2 publications

(3 citation statements)

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“…One of the larger studies did find similar correlations between CEA level and overall survival to our study, though specific to mucinous epithelial appendiceal cancers 11 . Another study found a similar correlation between elevated CEA levels and higher stage and higher grade using the SEER (Surveillance, Epidemiology, and End Results) database 20 . However, this study did not examine survival, and the SEER database does not contain reliable chemotherapy information.…”

Section: Discussionsupporting

confidence: 74%

“…Some of these studies also had broader scopes, such as Another study found a similar correlation between elevated CEA levels and higher stage and higher grade using the SEER (Surveillance, Epidemiology, and End Results) database. 20 However, this study did not examine survival, and the SEER database does not contain reliable chemotherapy information. The NCDB used in our study does have reliable chemotherapy data allowing us to perform subanalyses with neo-adjuvant chemotherapy and to control for receipt of chemotherapy in multivariate analyses.…”

Section: Discussionmentioning

confidence: 99%

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Cancer embryonic antigen (CEA) levels in patients with appendiceal adenocarcinoma predict response to neo‐adjuvant chemotherapy and overall survival

Norain

Stucky

Ahmad

et al. 2022

Journal of Surgical Oncology

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Background and Objectives Serum tumor markers are widely used for diagnosis, prognosis, treatment response, and surveillance. Our study evaluated cancer embryonic antigen (CEA) in patients with appendiceal adenocarcinoma. Methods The National Cancer Database was reviewed (2004–2011) for patients with surgical treatment for appendiceal adenocarcinoma. Patients were stratified into two groups: normal and elevated CEA. Multivariable adjusted Cox proportional hazards regression analyses were used to determine the independent effect of CEA on survival. Results Our study consisted of 2867 patients, 54.0% having elevated CEA. Patients with elevated CEA were more likely to have Stage IV disease, be female, and African American; all p < 0.001. Three‐year overall survival (OS) was significantly higher with normal CEA (75.5% vs. 62.8%, p < 0.001). On multivariable analysis, elevated CEA was associated with worse survival (hazard ratio 1.49, 95% confidence interval 1.23–1.80). Patients with elevated CEA had improved 3‐year OS with neo‐adjuvant compared to adjuvant chemotherapy (p = 0.004), while those with normal CEA showed no difference. Conclusions In patients with surgically treated appendiceal adenocarcinoma, preoperative elevation in CEA independently predicts decreased 3‐year survival and correlates with improved OS with neo‐adjuvant therapy. CEA levels should be considered in clinical decision‐making regarding neo‐adjuvant therapy in patients with appendiceal adenocarcinoma.

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Section: Discussionsupporting

confidence: 74%

Section: Discussionmentioning

confidence: 99%

Cancer embryonic antigen (CEA) levels in patients with appendiceal adenocarcinoma predict response to neo‐adjuvant chemotherapy and overall survival

Norain

Stucky

Ahmad

et al. 2022

Journal of Surgical Oncology

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“…CEA levels in AAdenoCa have been theorised to have a linear correlation with the amount of peritoneal disease and subsequently tumour burden as reflected by the PCI score. This hypothesis has arisen from studies demonstrating an association between elevated CEA and elevated PCI score, later stage, and higher grade of AAdenoCa and the normalisation of CEA post-CRS (17,21,22). In contrast, the relationship between serum CEA and peritoneal disease in CRAdenoCa patients is ambiguous, with some studies demonstrating its inferiority to Ca 19-9 as a diagnostic biomarker for peritoneal metastases and an insignificant correlation with PCI (18,23,24).…”

Section: Discussionmentioning

confidence: 99%

Increased Incidence of Liver Metastases in ColorectalVersusAppendiceal Adenocarcinoma Peritonectomy Patients Despite Equivocal Survival

GARRETT,

CRISTAUDO,

BARAT

et al. 2023

Anticancer Res

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Background/Aim: Colorectal adenocarcinoma (CRAdenoCa) and appendiceal adenocarcinoma (AAdenoCa) are diseases of the same histopathological type that metastasise to the liver and peritoneum. In selected subgroups, peritonectomy and heated intraperitoneal chemotherapy (HIPEC) may be indicated as part of the multimodal treatment plan. However, literature comparing the survival outcomes and preoperative tumour activity and burden of CRAdenoCa and AAdenoCa peritonectomy patients without synchronous liver metastases (sLM) is scarce. Little is also known about the comparative incidence of sLM and metachronous LM (mLM) between CRAdenoCa and AAdenoCa peritonectomy patients. This study aimed to clarify the above. Patients and Methods: A retrospective cohort study of 684 CRAdenoCa and AAdenoCa primary peritonectomy patients between 2001-2021 was conducted at St George Hospital in Sydney, Australia. Results: Median overall survival (years) was equivocal between CRAdenoCa and AAdenoCa peritonectomy patients (1.7 vs. 1.9, p=0.35). Peritoneal cancer index and preoperative carcinoembryonic antigen (CEA) were significantly elevated (25 vs. 9, p<0.0001 and 7.9 vs. 5, p=0.0080) in AAdenoCa versus CRAdenoCa peritonectomy patients without sLM. The incidence of sLM and mLM was increased in CRAdenoCa peritonectomy patients (24% vs. 3.1%, p<0.0001 and 26% vs. 10%, p=0.0001). Conclusion: This study demonstrates similar survival outcomes between CRAdenoCa and AAdenoCa peritonectomy patients.Despite elevated preoperative tumour burden and biological activity in AAdenoCa patients, CRAdenoCa patients had higher rates of sLM and mLM. Further studies are warranted to validate and identify cellular and molecular targets that increase CRAdenoCa's ability to metastasise to the liver.

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Utility of carcinoembryonic antigen (CEA) in appendiceal carcinoma

Cited by 2 publications

References 0 publications

Cancer embryonic antigen (CEA) levels in patients with appendiceal adenocarcinoma predict response to neo‐adjuvant chemotherapy and overall survival

Cancer embryonic antigen (CEA) levels in patients with appendiceal adenocarcinoma predict response to neo‐adjuvant chemotherapy and overall survival

Increased Incidence of Liver Metastases in ColorectalVersusAppendiceal Adenocarcinoma Peritonectomy Patients Despite Equivocal Survival

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