Preoperative Serum Carcinoembryonic Antigen Level as a Prognostic Factor for Recurrence and Survival After Curative Resection Followed by Adjuvant Chemotherapy in Stage III Colon Cancer

Chang Gon Kim, Joong Bae Ahn, Minkyu Jung, Seung Hoon Beom, Su Jin Heo, Jee Hung Kim, Young Jin Kim, Namkyu Kim, Byung Soh Min, Woong Sub Koom, Hoguen Kim, Yun Ho Roh, Bo Gyoung Ma, Sang Joon Shin

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background: Carcinoembryonic antigen (CEA) is the most widely used tumor marker in colon cancer; however, there has been controversy regarding the significance of preoperative serum CEA level as a prognostic factor for recurrence. In this study, we evaluated the optimal cutoff value and prognostic significance of preoperative serum CEA level in stage III colon cancer. Methods: Based on a retrospective cohort of 965 patients with stage III colon cancer who underwent elective curative surgery and adjuvant chemotherapy with fluoropyrimidine and oxaliplatin (training set), we determined the optimal cutoff value of CEA for recurrence using the Contal and O’Quigley method. We assessed the prognostic value of this cutoff value in terms of disease-free survival (DFS) and overall survival (OS) in a prospective cohort of 268 patients with stage III colon cancer (validation set). A Cox proportional hazards model was used to explore the association of prognostic variables with DFS and OS. Results: The statistically determined best cutoff value for CEA was 3 ng/mL in the training set. A high CEA level (≥3 ng/mL) was associated with inferior DFS (hazard ratio [HR] 4.609, 95 % confidence interval [CI] 2.028–10.474) and OS (HR 3.956, 95 % CI 1.127–13.882) in the validation set, while multivariate analysis showed that a high CEA level was an independent risk factor for DFS and OS in both study subsets. Conclusion: Preoperative serum CEA level is an independent prognostic factor for DFS and OS in patients with stage III colon cancer after curative resection and adjuvant chemotherapy.

Original languageEnglish
Pages (from-to)227-235
Number of pages9
JournalAnnals of Surgical Oncology
Volume24
Issue number1
DOIs
Publication statusPublished - 2017 Jan 1

Fingerprint

Carcinoembryonic Antigen
Adjuvant Chemotherapy
Colonic Neoplasms
Recurrence
Survival
Disease-Free Survival
Serum
oxaliplatin
Confidence Intervals
Tumor Biomarkers
Proportional Hazards Models
Multivariate Analysis

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Kim, Chang Gon ; Ahn, Joong Bae ; Jung, Minkyu ; Beom, Seung Hoon ; Heo, Su Jin ; Kim, Jee Hung ; Kim, Young Jin ; Kim, Namkyu ; Min, Byung Soh ; Koom, Woong Sub ; Kim, Hoguen ; Roh, Yun Ho ; Ma, Bo Gyoung ; Shin, Sang Joon. / Preoperative Serum Carcinoembryonic Antigen Level as a Prognostic Factor for Recurrence and Survival After Curative Resection Followed by Adjuvant Chemotherapy in Stage III Colon Cancer. In: Annals of Surgical Oncology. 2017 ; Vol. 24, No. 1. pp. 227-235.
@article{21158da880914bc48b46aa5bf810f4ac,
title = "Preoperative Serum Carcinoembryonic Antigen Level as a Prognostic Factor for Recurrence and Survival After Curative Resection Followed by Adjuvant Chemotherapy in Stage III Colon Cancer",
abstract = "Background: Carcinoembryonic antigen (CEA) is the most widely used tumor marker in colon cancer; however, there has been controversy regarding the significance of preoperative serum CEA level as a prognostic factor for recurrence. In this study, we evaluated the optimal cutoff value and prognostic significance of preoperative serum CEA level in stage III colon cancer. Methods: Based on a retrospective cohort of 965 patients with stage III colon cancer who underwent elective curative surgery and adjuvant chemotherapy with fluoropyrimidine and oxaliplatin (training set), we determined the optimal cutoff value of CEA for recurrence using the Contal and O’Quigley method. We assessed the prognostic value of this cutoff value in terms of disease-free survival (DFS) and overall survival (OS) in a prospective cohort of 268 patients with stage III colon cancer (validation set). A Cox proportional hazards model was used to explore the association of prognostic variables with DFS and OS. Results: The statistically determined best cutoff value for CEA was 3 ng/mL in the training set. A high CEA level (≥3 ng/mL) was associated with inferior DFS (hazard ratio [HR] 4.609, 95 {\%} confidence interval [CI] 2.028–10.474) and OS (HR 3.956, 95 {\%} CI 1.127–13.882) in the validation set, while multivariate analysis showed that a high CEA level was an independent risk factor for DFS and OS in both study subsets. Conclusion: Preoperative serum CEA level is an independent prognostic factor for DFS and OS in patients with stage III colon cancer after curative resection and adjuvant chemotherapy.",
author = "Kim, {Chang Gon} and Ahn, {Joong Bae} and Minkyu Jung and Beom, {Seung Hoon} and Heo, {Su Jin} and Kim, {Jee Hung} and Kim, {Young Jin} and Namkyu Kim and Min, {Byung Soh} and Koom, {Woong Sub} and Hoguen Kim and Roh, {Yun Ho} and Ma, {Bo Gyoung} and Shin, {Sang Joon}",
year = "2017",
month = "1",
day = "1",
doi = "10.1245/s10434-016-5613-5",
language = "English",
volume = "24",
pages = "227--235",
journal = "Annals of Surgical Oncology",
issn = "1068-9265",
publisher = "Springer New York",
number = "1",

}

Preoperative Serum Carcinoembryonic Antigen Level as a Prognostic Factor for Recurrence and Survival After Curative Resection Followed by Adjuvant Chemotherapy in Stage III Colon Cancer. / Kim, Chang Gon; Ahn, Joong Bae; Jung, Minkyu; Beom, Seung Hoon; Heo, Su Jin; Kim, Jee Hung; Kim, Young Jin; Kim, Namkyu; Min, Byung Soh; Koom, Woong Sub; Kim, Hoguen; Roh, Yun Ho; Ma, Bo Gyoung; Shin, Sang Joon.

In: Annals of Surgical Oncology, Vol. 24, No. 1, 01.01.2017, p. 227-235.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Preoperative Serum Carcinoembryonic Antigen Level as a Prognostic Factor for Recurrence and Survival After Curative Resection Followed by Adjuvant Chemotherapy in Stage III Colon Cancer

AU - Kim, Chang Gon

AU - Ahn, Joong Bae

AU - Jung, Minkyu

AU - Beom, Seung Hoon

AU - Heo, Su Jin

AU - Kim, Jee Hung

AU - Kim, Young Jin

AU - Kim, Namkyu

AU - Min, Byung Soh

AU - Koom, Woong Sub

AU - Kim, Hoguen

AU - Roh, Yun Ho

AU - Ma, Bo Gyoung

AU - Shin, Sang Joon

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: Carcinoembryonic antigen (CEA) is the most widely used tumor marker in colon cancer; however, there has been controversy regarding the significance of preoperative serum CEA level as a prognostic factor for recurrence. In this study, we evaluated the optimal cutoff value and prognostic significance of preoperative serum CEA level in stage III colon cancer. Methods: Based on a retrospective cohort of 965 patients with stage III colon cancer who underwent elective curative surgery and adjuvant chemotherapy with fluoropyrimidine and oxaliplatin (training set), we determined the optimal cutoff value of CEA for recurrence using the Contal and O’Quigley method. We assessed the prognostic value of this cutoff value in terms of disease-free survival (DFS) and overall survival (OS) in a prospective cohort of 268 patients with stage III colon cancer (validation set). A Cox proportional hazards model was used to explore the association of prognostic variables with DFS and OS. Results: The statistically determined best cutoff value for CEA was 3 ng/mL in the training set. A high CEA level (≥3 ng/mL) was associated with inferior DFS (hazard ratio [HR] 4.609, 95 % confidence interval [CI] 2.028–10.474) and OS (HR 3.956, 95 % CI 1.127–13.882) in the validation set, while multivariate analysis showed that a high CEA level was an independent risk factor for DFS and OS in both study subsets. Conclusion: Preoperative serum CEA level is an independent prognostic factor for DFS and OS in patients with stage III colon cancer after curative resection and adjuvant chemotherapy.

AB - Background: Carcinoembryonic antigen (CEA) is the most widely used tumor marker in colon cancer; however, there has been controversy regarding the significance of preoperative serum CEA level as a prognostic factor for recurrence. In this study, we evaluated the optimal cutoff value and prognostic significance of preoperative serum CEA level in stage III colon cancer. Methods: Based on a retrospective cohort of 965 patients with stage III colon cancer who underwent elective curative surgery and adjuvant chemotherapy with fluoropyrimidine and oxaliplatin (training set), we determined the optimal cutoff value of CEA for recurrence using the Contal and O’Quigley method. We assessed the prognostic value of this cutoff value in terms of disease-free survival (DFS) and overall survival (OS) in a prospective cohort of 268 patients with stage III colon cancer (validation set). A Cox proportional hazards model was used to explore the association of prognostic variables with DFS and OS. Results: The statistically determined best cutoff value for CEA was 3 ng/mL in the training set. A high CEA level (≥3 ng/mL) was associated with inferior DFS (hazard ratio [HR] 4.609, 95 % confidence interval [CI] 2.028–10.474) and OS (HR 3.956, 95 % CI 1.127–13.882) in the validation set, while multivariate analysis showed that a high CEA level was an independent risk factor for DFS and OS in both study subsets. Conclusion: Preoperative serum CEA level is an independent prognostic factor for DFS and OS in patients with stage III colon cancer after curative resection and adjuvant chemotherapy.

UR - http://www.scopus.com/inward/record.url?scp=84989809135&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84989809135&partnerID=8YFLogxK

U2 - 10.1245/s10434-016-5613-5

DO - 10.1245/s10434-016-5613-5

M3 - Article

VL - 24

SP - 227

EP - 235

JO - Annals of Surgical Oncology

JF - Annals of Surgical Oncology

SN - 1068-9265

IS - 1

ER -