Prognostic Impact of the Postoperative Carcinoembryonic Antigen Level after Curative Resection of Locally Advanced Rectal Cancer
Objectives: This study was conducted to investigate whether preoperative or postoperative carcinoembryonic antigen (CEA) with a new cut-off value is more optimal for predicting long-term outcomes in patients with Stage II/III rectal cancer, and to investigate the effectiveness of postoperative adjuv...
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| Format: | Article |
| Language: | English |
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The Japan Society of Coloproctology
2025-01-01
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| Series: | Journal of the Anus, Rectum and Colon |
| Subjects: | |
| Online Access: | https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-035/_pdf/-char/en |
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| _version_ | 1832584947217465344 |
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| author | Ryoichi Tsukamoto Kiichi Sugimoto Yuki Ii Takahiro Irie Megumi Kawaguchi Aya Kobari Yuki Tsuchiya Kumpei Honjo Masaya Kawai Shun Ishiyama Makoto Takahashi Kazuhiro Sakamoto |
| author_facet | Ryoichi Tsukamoto Kiichi Sugimoto Yuki Ii Takahiro Irie Megumi Kawaguchi Aya Kobari Yuki Tsuchiya Kumpei Honjo Masaya Kawai Shun Ishiyama Makoto Takahashi Kazuhiro Sakamoto |
| author_sort | Ryoichi Tsukamoto |
| collection | DOAJ |
| description | Objectives: This study was conducted to investigate whether preoperative or postoperative carcinoembryonic antigen (CEA) with a new cut-off value is more optimal for predicting long-term outcomes in patients with Stage II/III rectal cancer, and to investigate the effectiveness of postoperative adjuvant chemotherapy (POAC) based on the CEA values.
Methods: Serum CEA levels were measured preoperatively (pre-CEA) and postoperatively (post-CEA). The area under the receiver operating curve (AUROC) was used to determine a cut-off for CEA. The cut-off for CEA relative to recurrence-free survival (RFS) was established as that giving the highest AUROC. In comparison of superiority between pre- and post- CEA levels, Akaike's information criterion (AIC) was used in the Cox proportional-hazard regression model.
Results: The subjects were 323 patients who underwent curative surgical treatment for Stage II/III rectal cancer. AIC values indicated that RFS was better stratified by a post-CEA level with a cut-off of 2.3 ng/ml compared with other classifications of pre- or post- CEA. In Stage III or high-risk Stage II cases, there was no effect of POAC on RFS in those with post-CEA <2.3 ng/ml (p=0.39), but in those with post-CEA 2.3 ng/ml there was a trend for better RFS in patients who received POAC compared to those without POAC (p=0.06).
Conclusions: Patients with post-CEA 2.3 ng/ml had worse long-term outcomes compared with those with post-CEA <2.3 ng/ml. Post-CEA with a cut-off of 2.3 ng/ml may be useful in determining the indication for POAC for in Stage III or high-risk Stage II cases. |
| format | Article |
| id | doaj-art-9fb623d42f4345d8a42ec142da431871 |
| institution | Kabale University |
| issn | 2432-3853 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | The Japan Society of Coloproctology |
| record_format | Article |
| series | Journal of the Anus, Rectum and Colon |
| spelling | doaj-art-9fb623d42f4345d8a42ec142da4318712025-01-27T10:02:40ZengThe Japan Society of ColoproctologyJournal of the Anus, Rectum and Colon2432-38532025-01-0191697810.23922/jarc.2024-0352024-035Prognostic Impact of the Postoperative Carcinoembryonic Antigen Level after Curative Resection of Locally Advanced Rectal CancerRyoichi Tsukamoto0Kiichi Sugimoto1Yuki Ii2Takahiro Irie3Megumi Kawaguchi4Aya Kobari5Yuki Tsuchiya6Kumpei Honjo7Masaya Kawai8Shun Ishiyama9Makoto Takahashi10Kazuhiro Sakamoto11Department of Coloproctological Surgery, Juntendo University Faculty of MedicineDepartment of Coloproctological Surgery, Juntendo University Faculty of MedicineDepartment of Coloproctological Surgery, Juntendo University Faculty of MedicineDepartment of Coloproctological Surgery, Juntendo University Faculty of MedicineDepartment of Coloproctological Surgery, Juntendo University Faculty of MedicineDepartment of Coloproctological Surgery, Juntendo University Faculty of MedicineDepartment of Coloproctological Surgery, Juntendo University Faculty of MedicineDepartment of Coloproctological Surgery, Juntendo University Faculty of MedicineDepartment of Coloproctological Surgery, Juntendo University Faculty of MedicineDepartment of Coloproctological Surgery, Juntendo University Faculty of MedicineDepartment of Coloproctological Surgery, Juntendo University Faculty of MedicineDepartment of Coloproctological Surgery, Juntendo University Faculty of MedicineObjectives: This study was conducted to investigate whether preoperative or postoperative carcinoembryonic antigen (CEA) with a new cut-off value is more optimal for predicting long-term outcomes in patients with Stage II/III rectal cancer, and to investigate the effectiveness of postoperative adjuvant chemotherapy (POAC) based on the CEA values. Methods: Serum CEA levels were measured preoperatively (pre-CEA) and postoperatively (post-CEA). The area under the receiver operating curve (AUROC) was used to determine a cut-off for CEA. The cut-off for CEA relative to recurrence-free survival (RFS) was established as that giving the highest AUROC. In comparison of superiority between pre- and post- CEA levels, Akaike's information criterion (AIC) was used in the Cox proportional-hazard regression model. Results: The subjects were 323 patients who underwent curative surgical treatment for Stage II/III rectal cancer. AIC values indicated that RFS was better stratified by a post-CEA level with a cut-off of 2.3 ng/ml compared with other classifications of pre- or post- CEA. In Stage III or high-risk Stage II cases, there was no effect of POAC on RFS in those with post-CEA <2.3 ng/ml (p=0.39), but in those with post-CEA 2.3 ng/ml there was a trend for better RFS in patients who received POAC compared to those without POAC (p=0.06). Conclusions: Patients with post-CEA 2.3 ng/ml had worse long-term outcomes compared with those with post-CEA <2.3 ng/ml. Post-CEA with a cut-off of 2.3 ng/ml may be useful in determining the indication for POAC for in Stage III or high-risk Stage II cases.https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-035/_pdf/-char/enlocally advanced rectal cancercarcinoembryonic antigen (cea)minimal residual disease (mrd)recurrence-free survivalpostoperative adjuvant chemotherapy (poac) |
| spellingShingle | Ryoichi Tsukamoto Kiichi Sugimoto Yuki Ii Takahiro Irie Megumi Kawaguchi Aya Kobari Yuki Tsuchiya Kumpei Honjo Masaya Kawai Shun Ishiyama Makoto Takahashi Kazuhiro Sakamoto Prognostic Impact of the Postoperative Carcinoembryonic Antigen Level after Curative Resection of Locally Advanced Rectal Cancer Journal of the Anus, Rectum and Colon locally advanced rectal cancer carcinoembryonic antigen (cea) minimal residual disease (mrd) recurrence-free survival postoperative adjuvant chemotherapy (poac) |
| title | Prognostic Impact of the Postoperative Carcinoembryonic Antigen Level after Curative Resection of Locally Advanced Rectal Cancer |
| title_full | Prognostic Impact of the Postoperative Carcinoembryonic Antigen Level after Curative Resection of Locally Advanced Rectal Cancer |
| title_fullStr | Prognostic Impact of the Postoperative Carcinoembryonic Antigen Level after Curative Resection of Locally Advanced Rectal Cancer |
| title_full_unstemmed | Prognostic Impact of the Postoperative Carcinoembryonic Antigen Level after Curative Resection of Locally Advanced Rectal Cancer |
| title_short | Prognostic Impact of the Postoperative Carcinoembryonic Antigen Level after Curative Resection of Locally Advanced Rectal Cancer |
| title_sort | prognostic impact of the postoperative carcinoembryonic antigen level after curative resection of locally advanced rectal cancer |
| topic | locally advanced rectal cancer carcinoembryonic antigen (cea) minimal residual disease (mrd) recurrence-free survival postoperative adjuvant chemotherapy (poac) |
| url | https://www.jstage.jst.go.jp/article/jarc/9/1/9_2024-035/_pdf/-char/en |
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