Prognostic value of postoperative CEA clearance in rectal cancer patients with high preoperative CEA levels

Jeong Yeon Kim, Namkyu Kim, Seung Kook Sohn, YoungWan Kim, Kim Jin Soo Kim, Hyuk Hur, Byung Soh Min, Chang Hwan Cho

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30 Citations (Scopus)

Abstract

Purpose. We determined the prognostic value of carcinoembryonic antigen (CEA) clearance after tumor resection with serial evaluation of postoperative CEA levels in rectal cancer. Methods. Between 1994 and 2004, we retrospectively reviewed 122 patients with rectal cancer whose serum CEA levels were measured on the preoperative day and postoperative days 7 and 30. Patients with preoperative CEA levels <5.0 ng/ml were excluded. An exponential trend line was drawn using the three CEA values. Patients were categorized into three groups based onR2 values calculated through trend line, which indicates the correlation coefficient between exponential graph and measured CEA values: exponential decrease group (group 1: 0.9<R2 ≤ 1.0), nearly exponential decrease group (group 2: 0.5<R2 ≤ 0.9), and randomized clearance group (group 3: 0.5 ≤ R2). We then analyzed the CEA clearance pattern as a prognostic indicator. Results. With a median follow-up of 57 months, the 5-year overall survival was 62.3% vs. 48.1% vs. 25% and the 5-year disease-free survival was 58.6% vs. 52.7% vs. 25% among groups 1, 2, and 3 (P = 0.014, P = 0.027, respectively) in patients with stage III rectal cancer. For those with stage II rectal cancer, the 5-year overall survival rate of group 1 was significantly better than groups 2 and 3 (88.8% vs. 74.1%, respectively, P = 0.021). Conclusions. The postoperative pattern of CEA clearance is a useful prognostic determinant in patients with rectal cancer. Patientswith a randomized pattern of CEA clearance after tumor resection should be regarded as having the possibility of a persistent CEA source and may require consideration of intensive follow-up or adjuvant therapy.

Original languageEnglish
Pages (from-to)2771-2778
Number of pages8
JournalAnnals of Surgical Oncology
Volume16
Issue number10
DOIs
Publication statusPublished - 2009 Oct 1

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Carcinoembryonic Antigen
Rectal Neoplasms
Disease-Free Survival
Neoplasms
Survival Rate
Survival

All Science Journal Classification (ASJC) codes

  • Surgery
  • Oncology

Cite this

Kim, Jeong Yeon ; Kim, Namkyu ; Sohn, Seung Kook ; Kim, YoungWan ; Soo Kim, Kim Jin ; Hur, Hyuk ; Min, Byung Soh ; Cho, Chang Hwan. / Prognostic value of postoperative CEA clearance in rectal cancer patients with high preoperative CEA levels. In: Annals of Surgical Oncology. 2009 ; Vol. 16, No. 10. pp. 2771-2778.
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title = "Prognostic value of postoperative CEA clearance in rectal cancer patients with high preoperative CEA levels",
abstract = "Purpose. We determined the prognostic value of carcinoembryonic antigen (CEA) clearance after tumor resection with serial evaluation of postoperative CEA levels in rectal cancer. Methods. Between 1994 and 2004, we retrospectively reviewed 122 patients with rectal cancer whose serum CEA levels were measured on the preoperative day and postoperative days 7 and 30. Patients with preoperative CEA levels <5.0 ng/ml were excluded. An exponential trend line was drawn using the three CEA values. Patients were categorized into three groups based onR2 values calculated through trend line, which indicates the correlation coefficient between exponential graph and measured CEA values: exponential decrease group (group 1: 0.9<R2 ≤ 1.0), nearly exponential decrease group (group 2: 0.5<R2 ≤ 0.9), and randomized clearance group (group 3: 0.5 ≤ R2). We then analyzed the CEA clearance pattern as a prognostic indicator. Results. With a median follow-up of 57 months, the 5-year overall survival was 62.3{\%} vs. 48.1{\%} vs. 25{\%} and the 5-year disease-free survival was 58.6{\%} vs. 52.7{\%} vs. 25{\%} among groups 1, 2, and 3 (P = 0.014, P = 0.027, respectively) in patients with stage III rectal cancer. For those with stage II rectal cancer, the 5-year overall survival rate of group 1 was significantly better than groups 2 and 3 (88.8{\%} vs. 74.1{\%}, respectively, P = 0.021). Conclusions. The postoperative pattern of CEA clearance is a useful prognostic determinant in patients with rectal cancer. Patientswith a randomized pattern of CEA clearance after tumor resection should be regarded as having the possibility of a persistent CEA source and may require consideration of intensive follow-up or adjuvant therapy.",
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Prognostic value of postoperative CEA clearance in rectal cancer patients with high preoperative CEA levels. / Kim, Jeong Yeon; Kim, Namkyu; Sohn, Seung Kook; Kim, YoungWan; Soo Kim, Kim Jin; Hur, Hyuk; Min, Byung Soh; Cho, Chang Hwan.

In: Annals of Surgical Oncology, Vol. 16, No. 10, 01.10.2009, p. 2771-2778.

Research output: Contribution to journalArticle

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AU - Kim, Jeong Yeon

AU - Kim, Namkyu

AU - Sohn, Seung Kook

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AU - Soo Kim, Kim Jin

AU - Hur, Hyuk

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N2 - Purpose. We determined the prognostic value of carcinoembryonic antigen (CEA) clearance after tumor resection with serial evaluation of postoperative CEA levels in rectal cancer. Methods. Between 1994 and 2004, we retrospectively reviewed 122 patients with rectal cancer whose serum CEA levels were measured on the preoperative day and postoperative days 7 and 30. Patients with preoperative CEA levels <5.0 ng/ml were excluded. An exponential trend line was drawn using the three CEA values. Patients were categorized into three groups based onR2 values calculated through trend line, which indicates the correlation coefficient between exponential graph and measured CEA values: exponential decrease group (group 1: 0.9<R2 ≤ 1.0), nearly exponential decrease group (group 2: 0.5<R2 ≤ 0.9), and randomized clearance group (group 3: 0.5 ≤ R2). We then analyzed the CEA clearance pattern as a prognostic indicator. Results. With a median follow-up of 57 months, the 5-year overall survival was 62.3% vs. 48.1% vs. 25% and the 5-year disease-free survival was 58.6% vs. 52.7% vs. 25% among groups 1, 2, and 3 (P = 0.014, P = 0.027, respectively) in patients with stage III rectal cancer. For those with stage II rectal cancer, the 5-year overall survival rate of group 1 was significantly better than groups 2 and 3 (88.8% vs. 74.1%, respectively, P = 0.021). Conclusions. The postoperative pattern of CEA clearance is a useful prognostic determinant in patients with rectal cancer. Patientswith a randomized pattern of CEA clearance after tumor resection should be regarded as having the possibility of a persistent CEA source and may require consideration of intensive follow-up or adjuvant therapy.

AB - Purpose. We determined the prognostic value of carcinoembryonic antigen (CEA) clearance after tumor resection with serial evaluation of postoperative CEA levels in rectal cancer. Methods. Between 1994 and 2004, we retrospectively reviewed 122 patients with rectal cancer whose serum CEA levels were measured on the preoperative day and postoperative days 7 and 30. Patients with preoperative CEA levels <5.0 ng/ml were excluded. An exponential trend line was drawn using the three CEA values. Patients were categorized into three groups based onR2 values calculated through trend line, which indicates the correlation coefficient between exponential graph and measured CEA values: exponential decrease group (group 1: 0.9<R2 ≤ 1.0), nearly exponential decrease group (group 2: 0.5<R2 ≤ 0.9), and randomized clearance group (group 3: 0.5 ≤ R2). We then analyzed the CEA clearance pattern as a prognostic indicator. Results. With a median follow-up of 57 months, the 5-year overall survival was 62.3% vs. 48.1% vs. 25% and the 5-year disease-free survival was 58.6% vs. 52.7% vs. 25% among groups 1, 2, and 3 (P = 0.014, P = 0.027, respectively) in patients with stage III rectal cancer. For those with stage II rectal cancer, the 5-year overall survival rate of group 1 was significantly better than groups 2 and 3 (88.8% vs. 74.1%, respectively, P = 0.021). Conclusions. The postoperative pattern of CEA clearance is a useful prognostic determinant in patients with rectal cancer. Patientswith a randomized pattern of CEA clearance after tumor resection should be regarded as having the possibility of a persistent CEA source and may require consideration of intensive follow-up or adjuvant therapy.

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