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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

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Author(s)
Jong Hoon LeeDae Yong KimSung Hwan KimHyeon Min ChoByoung Yong ShimTae Hyun KimSun Young KimJi Yeon BaekJae Hwan OhTaek Keun NamMee Sun YoonJae Uk JeongKyubo KimEui Kyu ChieHong Seok JangJae-Sung KimJin Hee KimBae Kwon Jeong
Keimyung Author(s)
Kim, Jin Hee
Department
Dept. of Radiation Oncology (방사선종양학)
Journal Title
Radiotherapy and Oncology
Issued Date
2015
Volume
116
Issue
2
Keyword
CEA Chemoradiotherapy Rectal cancerResponseRecurrence
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 (65 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.
Keimyung Author(s)(Kor)
김진희
Publisher
School of Medicine
Citation
Jong Hoon Lee et al. (2015). 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. Radiotherapy and Oncology, 116(2), 202–208. doi: 10.1016/j.radonc.2015.07.049
Type
Article
ISSN
0167-8140
Source
https://www.sciencedirect.com/science/article/pii/S0167814015004223?via%3Dihub
DOI
10.1016/j.radonc.2015.07.049
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/32905
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학)
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