Yeungnam Univ J Med.  2017 Dec;34(2):216-221. 10.12701/yujm.2017.34.2.216.

Prognostic role of preoperative carcinoembryonic antigen levels in colorectal cancer: propensity score matching

• Kim CS
• Kim S

• KMID: 2400357
• DOI: http://doi.org/10.12701/yujm.2017.34.2.216

Abstract

BACKGROUND
This study was conducted to investigate preoperative carcinoembryonic antigen (CEA) as a prognostic factor in colorectal cancer.
METHODS
Between January 2000 and July 2011, 1298 patients with primary adenocarcinoma colorectal cancer without metastasis, who underwent curative resection were retrospectively identified. The patients were divided into two groups according to serum CEA level at primary diagnosis: a high CEA (HCEA) group (serum CEA ≥6 ng/mL) and a normal CEA (NCEA) group (serum CEA <6 ng/mL). A 1:1 propensity score matching analysis was applied to reduce bias. Finally, 364 patients were enrolled in this study. Matched variables were age, gender, preoperative chemoradiotherapy, tumor site, cell differentiation and pathologic stage.
RESULTS
The clinicopathological characteristics of the two groups did not differ significantly difference. The systemic metastasis rate was 16.5% (30/182) and 25.3% (46/182) in the NCEA and HCEA groups, respectively (p=0.039). There were no significant differences in local recurrence or metastatic sites between groups. The 5-year disease-free survival (DFS) rate of the HCEA group was worse than that of the NCEA group; however, there was no significant difference in overall survival between the two groups.
CONCLUSION
Elevated preoperative CEA was related to frequent systemic recurrence and low DFS. Therefore, elevated preoperative CEA could be considered a prognostic factor for worse clinical outcomes in patients with colorectal cancer.

Keyword

Carcinoembryonic antigen; Recurrence; Prognosis; Colorectal neoplasms

MeSH Terms

Adenocarcinoma
Bias (Epidemiology)
Carcinoembryonic Antigen*
Cell Differentiation
Chemoradiotherapy
Colorectal Neoplasms*
Diagnosis
Disease-Free Survival
Humans
Neoplasm Metastasis
Prognosis
Propensity Score*
Recurrence
Retrospective Studies
Carcinoembryonic Antigen