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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
- 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
- Lee, Jong Hoon; Kim, Nae Yong; Kim, Sung Hwan; Cho, Hyeon Min; Shim, Byoung Yong; Kim, Tae Hyun; Kim, Sun Young; Baek, Ji Yeon; Oh, Jae Hwan; Nam, Taek Keun; Yoon, Mee Sun; Jeong, Jae Uk; Kim, Kyubo; Chie, Eui Kyu; Jang, Hong Seok; Kim, Jae-Sung; Kim, Jin Hee; Jeong, Bae Kwon
- Ewha Authors
- SCOPUS Author ID
- Issue Date
- Journal Title
- RADIOTHERAPY AND ONCOLOGY
- RADIOTHERAPY AND ONCOLOGY vol. 116, no. 2, pp. 202 - 208
- CEA; Chemoradiotherapy; Rectal cancer; Response; Recurrence
- ELSEVIER IRELAND LTD
- SCIE; SCOPUS
- Document Type
- 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.
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