Preoperative Carcinoembryonic Antigen as a Poor Prognostic Factor in Stage I-III Colorectal Cancer After Curative-Intent Resection: A Propensity Score Matching Analysis

被引:32
|
作者
Huang, Shu-Huan [1 ]
Tsai, Wen-Sy [1 ,2 ]
You, Jeng-Fu [1 ]
Hung, Hsin-Yuan [1 ]
Yeh, Chien-Yuh [1 ]
Hsieh, Pao-Shiu [1 ]
Chiang, Sum-Fu [1 ]
Lai, Cheng-Chou [1 ]
Chiang, Jy-Ming [1 ]
Tang, Reiping [1 ]
Chen, Jinn-Shiun [1 ]
机构
[1] Chang Gung Mem Hosp, Div Colon & Rectal Surg, Linkou, Taiwan
[2] Chang Gung Univ, Coll Med, Taoyuan, Taiwan
关键词
COLON-CANCER; ADJUVANT CHEMOTHERAPY; RISK-FACTORS; LEVEL; SURVIVAL; SURVEILLANCE; FLUOROURACIL; RECURRENCE; ELEVATION; FAMILY;
D O I
10.1245/s10434-019-07184-3
中图分类号
R73 [肿瘤学];
学科分类号
100214 ;
摘要
BackgroundPreoperative carcinoembryonic antigen (CEA) has yet to be used as a prognostic or adjuvant chemotherapy factor for colorectal cancer (CRC).MethodsThis retrospective cohort study included all stage I-III CRC patients with different preoperative serum CEA levels (5, 5-10, and>10ng/ml) at a single center between 1995 and 2010. Propensity score matching was performed in a 1:1 ratio between the two elevated CEA groups (5-10ng/ml and>10ng/ml) and in a 1:2 ratio between the elevated and non-elevated groups (5ng/ml), with a caliper of 0.05.ResultsAfter exclusion and matching, 3857 patients had preoperative CEA levels5ng/ml, 1121 patients had CEA levels between 5 and 10ng/ml, and 1121 patients had CEA levels>10ng/ml. Elevated preoperative CEA showed an increased risk of overall survival (5-10ng/ml: hazard ratio [HR] 1.376;>10ng/ml:HR1.523; both p<0.001), cancer-specific survival (5-10ng/ml: HR 1.404;>10ng/ml:HR1.712; both p<0.001), and recurrence free interval (5-10ng/ml: HR 1.190;>10ng/ml:HR 1.468; both p<0.05). Patients with negative lymph node staging (LNs) and CEA>10ng/ml, as well as those with positive LNs and CEA5ng/ml, showed similar overall survival (5-year survival: 72% vs. 69%; p=0.542) and recurrence free intervals (19.9 vs. 21.72months; p=0.662).ConclusionsA preoperative CEA level can be an independent prognostic factor for stage I-III CRC after curative resection. Patients with negative LNs and preoperative CEA level>10ng/ml should be considered for intensive follow-up or adjuvant chemotherapy.
引用
收藏
页码:1685 / 1694
页数:10
相关论文
共 50 条
  • [1] Preoperative Carcinoembryonic Antigen as a Poor Prognostic Factor in Stage I–III Colorectal Cancer After Curative-Intent Resection: A Propensity Score Matching Analysis
    Shu-Huan Huang
    Wen-Sy Tsai
    Jeng-Fu You
    Hsin-Yuan Hung
    Chien-Yuh Yeh
    Pao-Shiu Hsieh
    Sum-Fu Chiang
    Cheng-Chou Lai
    Jy-Ming Chiang
    Reiping Tang
    Jinn-Shiun Chen
    [J]. Annals of Surgical Oncology, 2019, 26 : 1685 - 1694
  • [2] Elevated Carcinoembryonic Antigen at the Time of Recurrence as a Poor Prognostic Factor in Colorectal Cancer: A Propensity Score Matching Analysis
    Shin, Jung Kyong
    Huh, Jung Wook
    Lee, Woo Yong
    Yun, Seong Hyeon
    Kim, Hee Cheol
    Cho, Yong Beom
    Park, Yoon Ah
    [J]. FRONTIERS IN ONCOLOGY, 2022, 12
  • [3] ELEVATED CARCINOEMBRYONIC ANTIGEN AT THE TIME OF RECURRENCE AS A POOR PROGNOSTIC FACTOR IN COLORECTAL CANCER: A PROPENSITY SCORE MATCHING ANALYSIS.
    Huh, J.
    Shin, J.
    Park, Y.
    Cho, Y.
    Kim, H.
    Yun, S.
    Lee, W.
    [J]. DISEASES OF THE COLON & RECTUM, 2020, 63 (06) : E327 - E327
  • [4] Persistent presence of postoperative circulating tumor cells is a poor prognostic factor for patients with stage I-III colorectal cancer after curative resection
    Uen, Yih-Huei
    Lu, Chien-Yu
    Tsai, Hsiang-Lin
    Yu, Fang-Jung
    Huang, Ming-Yii
    Cheng, Tian-Lu
    Lin, Shiu-Ru
    Wang, Jaw-Yuan
    [J]. ANNALS OF SURGICAL ONCOLOGY, 2008, 15 (08) : 2120 - 2128
  • [5] Prognostic significance of the Naples prognostic score in colorectal cancer patients undergoing curative resection: a propensity score matching analysis
    Atsushi Sugimoto
    Tatsunari Fukuoka
    Masatsune Shibutani
    Hiroaki Kasashima
    Kishu Kitayama
    Masaichi Ohira
    Kiyoshi Maeda
    [J]. BMC Gastroenterology, 23
  • [6] Short course immunotherapy as curative-intent treatment in stage I-III dMMR rectal cancer
    Pfeiffer, Per
    Andersen, Per Vadgaard
    Salomon, Soren
    Ogaard, Nadia
    Demuth, Christina
    Andersen, Claus Lindbjerg
    Gogenur, Ismail
    Justesen, Tobias Freyberg
    de Lima, Vinicius Araujo
    Tarpgaard, Line Schmidt
    [J]. JOURNAL OF CLINICAL ONCOLOGY, 2024, 42 (3_SUPPL)
  • [7] Prognostic significance of the Naples prognostic score in colorectal cancer patients undergoing curative resection: a propensity score matching analysis
    Sugimoto, Atsushi
    Fukuoka, Tatsunari
    Shibutani, Masatsune
    Kasashima, Hiroaki
    Kitayama, Kishu
    Ohira, Masaichi
    Maeda, Kiyoshi
    [J]. BMC GASTROENTEROLOGY, 2023, 23 (01)
  • [8] Prognostic impact of preoperatively elevated and postoperatively normalized carcinoembryonic antigen levels following curative resection of stage I-III rectal cancer
    Nakamura, Yuya
    Shida, Dai
    Tanabe, Taro
    Takamizawa, Yasuyuki
    Imaizumi, Jun
    Ahiko, Yuka
    Sakamoto, Ryohei
    Moritani, Konosuke
    Tsukamoto, Shunsuke
    Kanemitsu, Yukihide
    [J]. CANCER MEDICINE, 2020, 9 (02): : 653 - 662
  • [9] Preoperative Serum Carcinoembryonic Antigen Level as a Predictive Factor of Recurrence After Curative Resection of Colorectal Cancer
    Takagawa, Ryo
    Fujii, Syoichi
    Ohta, Mitsuyoshi
    Nagano, Yasuhiko
    Kunisaki, Chikara
    Yamagishi, Shigeru
    Osada, Shunichi
    Ichikawa, Yasushi
    Shimada, Hiroshi
    [J]. ANNALS OF SURGICAL ONCOLOGY, 2008, 15 (12) : 3433 - 3439
  • [10] Preoperative Serum Carcinoembryonic Antigen Level as a Predictive Factor of Recurrence After Curative Resection of Colorectal Cancer
    Ryo Takagawa
    Syoichi Fujii
    Mitsuyoshi Ohta
    Yasuhiko Nagano
    Chikara Kunisaki
    Shigeru Yamagishi
    Shunichi Osada
    Yasushi Ichikawa
    Hiroshi Shimada
    [J]. Annals of Surgical Oncology, 2008, 15 : 3433 - 3439