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Prognostic Significance of the Decreased Rate of Perioperative Serum Carcinoembryonic Antigen Level in the Patients With Colon Cancer After a Curative Resection

대한대장항문학회지 2013년 29권 3호 p.115 ~ 122
 ( Jung Tae-Doo ) - Inje University Busan Paik Hospital Department of Surgery

 ( Yoo Jong-Han ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Lee Min-Jae ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Park Ha-Kyung ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Shin Jae-Ho ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( An Min-Sung ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Ha Tae-Kwun ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Kim Kwang-Hee ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Bae Ki-Beom ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Kim Tae-Hyeon ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Choi Chang-Soo ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Hong Kwan-Hee ) - Inje University College of Medicine Busan Paik Hospital Department of Surgery
 ( Oh Min-Kyung ) - Inje University College of Medicine Clinical Trial Center in Pharmacology

Abstract


Purpose: The serum level of carcinoembryonic antigen (CEA) is a clinical prognostic factor in the follow-up evaluation of patients with colon cancer. We aimed to evaluate the prognostic significance of the rate of decrease of the perioperative serum CEA level in patients with colon cancer after a curative resection.

Methods: A total of 605 patients who underwent a curative resection for colon cancer between January 2000 and December 2007 were enrolled retrospectively. The rate of decrease was calculated using the following equation: ([preoperative CEA - postoperative CEA]/[preoperative CEA] ×100).

Results: In the group with a preoperative serum CEA level of >5 ng/mL, the normalized group with a postoperative serum CEA level of ≤5 ng/mL showed a better overall survival (OS) rate and disease-free survival (DFS) rate than those of the non-normalized group (P ≤ 0.0001). The "cutoff values" of the rate of decrease in the perioperative serum CEA that determined the OS and the DFS were 48.9% and 50.8%, respectively. In the multivariate analysis of preoperative serum CEA levels >5 ng/mL, the prognostic factors for the OS and the DFS were the cutoff value (P < 0.0001) and the pN stage (P < 0.0001).

Conclusion: A rate of decrease of more than 50% in the perioperative serum CEA level, as well as the normalization of the postoperative serum CEA level, may be useful factors for determining a prognosis for colon cancer patients with high preoperative CEA levels.

키워드

Colon neoplasms;Carcinoembryonic antigen;Prognostic factor
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