Preoperative Serum Carcinoembryonic Antigen Level as a Prognostic Factor for Recurrence and Survival After Curative Resection Followed by Adjuvant Chemotherapy ... View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2016-10-03

AUTHORS

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

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.MethodsBased 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.ResultsThe 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.ConclusionPreoperative 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. More... »

PAGES

227-235

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-016-5613-5

DOI

http://dx.doi.org/10.1245/s10434-016-5613-5

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1024003759

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27699609


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36 schema:description 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.MethodsBased 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.ResultsThe 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.ConclusionPreoperative 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.
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43 schema:keywords Background Carcinoembryonic antigen
44 CEA levels
45 ConclusionPreoperative serum CEA level
46 Contal
47 Cox proportional hazards model
48 III colon cancer
49 MethodsBased
50 O’Quigley method
51 ResultsThe
52 adjuvant chemotherapy
53 analysis
54 antigen
55 antigen levels
56 association
57 best cutoff value
58 cancer
59 carcinoembryonic antigen
60 carcinoembryonic antigen level
61 chemotherapy
62 cohort
63 colon cancer
64 controversy
65 curative resection
66 curative surgery
67 cutoff value
68 disease-free survival
69 elective curative surgery
70 factors
71 fluoropyrimidines
72 hazards model
73 high CEA level
74 independent prognostic factor
75 independent risk factor
76 inferior disease-free survival
77 levels
78 markers
79 method
80 model
81 multivariate analysis
82 optimal cutoff value
83 overall survival
84 oxaliplatin
85 patients
86 preoperative serum CEA level
87 preoperative serum carcinoembryonic antigen (CEA) level
88 prognostic factors
89 prognostic significance
90 prognostic value
91 prognostic variables
92 proportional hazards model
93 prospective cohort
94 recurrence
95 resection
96 retrospective cohort
97 risk factors
98 serum CEA level
99 serum carcinoembryonic antigen level
100 set
101 significance
102 stage III colon cancer
103 study
104 study subset
105 subset
106 surgery
107 survival
108 terms
109 training set
110 tumor markers
111 validation set
112 values
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