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Preoperative Carcinoembryonic Antigen Level Predicts Prognosis in Patients with Pseudomyxoma Peritonei Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy

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Abstract

Background

Even though management of pseudomyxoma peritonei (PMP) was improved with cytoreductive surgery (CRS) and hyperthermic chemotherapy (HIPEC), several aspects of PMP still need to be optimized, including patient selection for surgery and prognostic factors. We assessed the role of preoperative carcinoembryonic antigen (CEA) levels in PMP patients treated with CRS and HIPEC.

Methods

A total of 449 PMP patients with documented preoperative CEA levels referred to our center between 2005 and 2011 underwent CRS and HIPEC. The association between CEA levels and characteristics of patients with PMP was assessed with χ 2 test, linear correlation, and logistic regression analyses. Survival analysis was performed with Cox proportional hazard model.

Results

Median age was 55 (range 19–84) years. There were 245 (54.5 %) females and 204 (45.5 %) males. Preoperative CEA levels were elevated in 328 (73 %, sensitivity) patients with PMP. Preoperative CEA levels were also related to peritoneal cancer index (P < 0.0001), cytoreductive surgery scores (P < 0.0001), progress free survival (P < 0.001) and overall survival (P < 0.001) in patients with PMP.

Conclusions

Our results indicated that preoperative CEA levels are useful in predicting the extent of disease and surgical success as well as progress-free and overall survival in patients with PMP treated with cytoreductive surgery and HIPEC.

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Authors and Affiliations

  1. NPO Organization to Support Peritoneal Dissemination Treatment, 1-26, Harukimotomachi, Kishiwada City, Osaka, 596-0032, Japan

    Emel Canbay, Haruaki Ishibashi, Shouzou Sako & Yutaka Yonemura

  2. Department of General Surgery, Kishiwada Tokushukai Hospital, 4-27-1 Kamori-Cho, Kishiwada City, Osaka, 596-8522, Japan

    Emel Canbay, Haruaki Ishibashi, Shouzou Sako & Yutaka Yonemura

  3. Department of General Surgery, Kocaeli-Derince Education and Research Hospital, Kocaeli, 41900, Turkey

    Emel Canbay

  4. Department of General Surgery, Kusatsu General Hospital, Yabase, 1660, Japan

    Emel Canbay, Akiyoshi Mizumoto, Masamitsu Hirano, Masumi Ichinose, Nobuyuki Takao & Yutaka Yonemura

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  1. Emel Canbay
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  2. Haruaki Ishibashi
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  3. Shouzou Sako
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  4. Akiyoshi Mizumoto
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  5. Masamitsu Hirano
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  6. Masumi Ichinose
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  7. Nobuyuki Takao
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  8. Yutaka Yonemura
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Correspondence to Emel Canbay.

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Canbay, E., Ishibashi, H., Sako, S. et al. Preoperative Carcinoembryonic Antigen Level Predicts Prognosis in Patients with Pseudomyxoma Peritonei Treated with Cytoreductive Surgery and Hyperthermic Intraperitoneal Chemotherapy. World J Surg 37, 1271–1276 (2013). https://doi.org/10.1007/s00268-013-1988-7

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  • DOI: https://doi.org/10.1007/s00268-013-1988-7

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