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Elevation of Preoperative s-CEA Concentration in Stage IIA Colorectal Cancer Can Also Be a High Risk Factor for Stage II Patients

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate stage IIA colorectal cancer in terms of recurrence so as to discover whether high preoperative serum carcinoembryonic antigen (s-CEA) levels indicate that the patient should be included in a high-risk group in stage II colorectal cancer.

Methods

We retrospectively reviewed the records of 1543 patients with stage IIA colorectal cancer who underwent curative surgery between January 2000 and December 2007.

Results

The 5-year disease-free survival and overall survival rates were significantly lower in patients with a higher than normal preoperative s-CEA (90.5 % vs. 82.5 %, P < 0.001, and 92.4 % vs. 87.8 %, P = 0.034, respectively). Multivariate analysis revealed that elevated preoperative s-CEA level, preoperative obstruction, rectal cancer, and dissection of fewer than 12 nodes were independent statistically significant prognostic factors that predicted disease-free survival in patients with stage IIA disease after curative resection.

Conclusions

Elevated preoperative s-CEA concentration is a reliable predictor of recurrence after curative resection in patients with stage IIA colorectal cancer. Patients with stage IIA disease with elevated preoperative s-CEA level do worse than those with normal levels and might constitute a group to evaluate for adjuvant chemotherapy. Further studies on the effect of adjuvant chemotherapy in this group are needed.

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Acknowledgment

Supported in part by the Asan Institute for Life Sciences (2011-069), and the Korea Health 21 R&D Project (A062254), Ministry of Health, Welfare, and Family Affairs, Republic of Korea.

Disclosure

The authors declare no conflict of interest.

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Authors and Affiliations

  1. Department of Surgery, Institute of Innovative Cancer Research, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea

    Chan Wook Kim MD, Yong Sik Yoon MD, In Ja Park MD, Seok-Byung Lim MD, Chang Sik Yu MD & Jin Cheon Kim MD

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  1. Chan Wook Kim MD
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  2. Yong Sik Yoon MD
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  3. In Ja Park MD
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  4. Seok-Byung Lim MD
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Correspondence to Jin Cheon Kim MD.

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Kim, C.W., Yoon, Y.S., Park, I.J. et al. Elevation of Preoperative s-CEA Concentration in Stage IIA Colorectal Cancer Can Also Be a High Risk Factor for Stage II Patients. Ann Surg Oncol 20, 2914–2920 (2013). https://doi.org/10.1245/s10434-013-2919-4

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  • DOI: https://doi.org/10.1245/s10434-013-2919-4

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