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Clinical Significance of Pre- to Post-Chemoradiotherapy s-CEA Reduction Ratio in Rectal Cancer Patients Treated with Preoperative Chemoradiotherapy and Curative Resection

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate the clinical significance of a reduction in serum carcinoembryonic antigen (s-CEA) concentration ratio from before to after preoperative chemoradiotherapy (CRT) in terms of recurrence and prognostic factors in rectal cancer patients.

Methods

We retrospectively evaluated 333 rectal cancer patients who received preoperative CRT followed by surgery with curative intent between January 2000 and December 2006. Patients were divided into three groups: those with pre-CRT s-CEA ≤ 6 ng/mL (group 1), those with pre-CRT s-CEA > 6 mg/mL and post-CRT s-CEA ≥ 70% lower than pre-CRT s-CEA (group 2), and those with pre-CRT s-CEA > 6 mg/mL and post-CRT s-CEA < 70% lower or higher than pre-CRT s-CEA (group 3).

Results

The 5-year disease-free survival rate was similar in group 1 (76.0%) and group 2 (66.0%), but significantly lower in group 3 (39.5%) (p < 0.001). Multivariate analysis showed that CEA group 3, ypT stage, ypN stage, and type of surgery were independent prognostic factors for disease-free survival.

Conclusions

The reduction ratio of pre- to post-CRT s-CEA concentration may be an independent prognostic factor for disease-free survival following preoperative CRT and surgery in rectal cancer patients with initial s-CEA > 6 ng/mL.

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Conflict of interest

The authors declare no conflicts of interest.

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Authors and Affiliations

  1. Department of Colon & Rectal Surgery, University of Ulsan College of Medicine and Asan Medical Center, Songpa-Ku, Seoul, Korea

    Chan Wook Kim MD, Chang Sik Yu MD, Song-Soo Yang MD, Kyung Ho Kim MD, Yong Sik Yoon MD, Sang Nam Yoon MD, Seok-Byung Lim MD & Jin Cheon Kim MD

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  1. Chan Wook Kim MD
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  2. Chang Sik Yu MD
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Correspondence to Chang Sik Yu MD.

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Kim, C.W., Yu, C.S., Yang, SS. et al. Clinical Significance of Pre- to Post-Chemoradiotherapy s-CEA Reduction Ratio in Rectal Cancer Patients Treated with Preoperative Chemoradiotherapy and Curative Resection. Ann Surg Oncol 18, 3271–3277 (2011). https://doi.org/10.1245/s10434-011-1740-1

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  • DOI: https://doi.org/10.1245/s10434-011-1740-1

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