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Carcinoembryonic antigen has prognostic value for tumor downstaging and recurrence in rectal cancer after preoperative chemoradiotherapy and curative surgery: A multi-institutional and case-matched control study of KROG 14-12

Title
Carcinoembryonic antigen has prognostic value for tumor downstaging and recurrence in rectal cancer after preoperative chemoradiotherapy and curative surgery: A multi-institutional and case-matched control study of KROG 14-12
Authors
Lee, Jong HoonKim, Nae YongKim, Sung HwanCho, Hyeon MinShim, Byoung YongKim, Tae HyunKim, Sun YoungBaek, Ji YeonOh, Jae HwanNam, Taek KeunYoon, Mee SunJeong, Jae UkKim, KyuboChie, Eui KyuJang, Hong SeokKim, Jae-SungKim, Jin HeeJeong, Bae Kwon
Ewha Authors
김규보
SCOPUS Author ID
김규보scopus
Issue Date
2015
Journal Title
RADIOTHERAPY AND ONCOLOGY
ISSN
0167-8140JCR Link
Citation
RADIOTHERAPY AND ONCOLOGY vol. 116, no. 2, pp. 202 - 208
Keywords
CEAChemoradiotherapyRectal cancerResponseRecurrence
Publisher
ELSEVIER IRELAND LTD
Indexed
SCIE; SCOPUS WOS
Document Type
Article
Abstract
Background and purpose: The Korean Radiation Oncology Group evaluated the significance of carcinoembryonic antigen (CEA) levels both as a predictor of tumor response after CRT and, as a prognosticator for recurrence-free survival. Methods and materials: 1804 rectal cancer patients,.staged cT3-4N0-2M0, participated in a multicenter study. The patients were administered preoperative radiation of 50.4 Gy in 28 fractions with 5-FU or capecitabine, followed by total mesorectal excision. Patients with elevated CEA levels (>5 ng/mL) were matched at a 1 (n = 595):1 (n = 595) ratio with patients with normal CEA ng/mL). The tumor response after CRT and the recurrence-free survival (RFS) rates were evaluated and compared between two arms. Results: An elevated CEA level (p < 0.001) was determined to be a significant negative predictor of downstaging after CRT. The downstaging rate was 42.9% for normal CEA and 23.4% for elevated CEA. A multivariate analysis also revealed that cT (p = 0.021) and cN classification (p = 0.001), tumor size (p = 0.002), and tumor location from the anal verge (p = 0.006) were significant predictors for tumor downstaging. The 5-year RFS rates were significantly higher for the normal CEA arm than for the elevated CEA arm (74.2 vs. 63.5%, p < 0.001). Conclusions: Elevated CEA (>5 ng/mL) is a negative predictor of tumor downstaging after CRT and also has a negative impact on RFS in rectal cancer. (C) 2015 Elsevier Ireland Ltd. All rights reserved.
DOI
10.1016/j.radonc.2015.07.049
Appears in Collections:
의과대학 > 의학과 > Journal papers
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