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Use of ascitic CEA levels as a predictive value for distant metastasis in high-risk stage II and III colorectal cancer

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

This study aimed to analyze the effect of ascitic carcinoembryonic antigen (CEA) levels on the long-term oncologic outcomes of colorectal cancer (CRC) following curative treatment.

Methods

A total of 191 patients with stage II/III CRC were included. CEA was analyzed on the peritoneal fluid samples taken at the start of each surgery. Long-term oncologic outcomes were analyzed using known risk factors for recurrence in CRC.

Result

Multivariate analysis of recurrence showed that lymphatic invasion (hazards ratio (HR) 2.7, 95% confidence interval (CI) 1.1–7, p = 0.038), vascular invasion (HR 2.8, 95% CI 1.2–6.3, p = 0.013), mucinous cancer (HR 3.6, 95% CI 1.3–10.1, p = 0.017), and peritoneal fluid CEA exceeding 5 ng/dl (odds ratio 3.1, 95% CI 1.2–7.7, p = 0.017) were significant risk factors. There were 14 patients with liver metastasis, 11 of whom had high ascitic CEA levels and no peritoneal metastasis. Additionally, eight had lung metastasis, and seven of them had high ascitic CEA levels.

Conclusion

High ascitic CEA levels showed significantly lower disease-free survival and were significantly associated with distant metastasis in the lung and liver.

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Data availability

The data that support the findings of this study are available from the corresponding author upon reasonable request.

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Author information

Authors and Affiliations

  1. Department of Surgery, College of Medicine, Taif University, Taif, Saudi Arabia

    Abdullah Al-Sawat

  2. Division of Colorectal Surgery, Department of Surgery, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, 222, Banpo-daero, Seocho-gu, Seoul, 06591, Republic of Korea

    Jung Hoon Bea, Seung-Rim Han, Hyo Jin Lee, Mi Ran Yoon, Yoon Suk Lee, Do Sang Lee, Chul Seung Lee & In Kyu Lee

Authors
  1. Abdullah Al-Sawat
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  2. Jung Hoon Bea
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  3. Seung-Rim Han
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  4. Hyo Jin Lee
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  5. Mi Ran Yoon
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  6. Yoon Suk Lee
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  7. Do Sang Lee
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  8. Chul Seung Lee
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  9. In Kyu Lee
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Contributions

Conceptualization and design: I.K.L. and C.S.L.; patient data and samples: A.A.S., H.J.L., and J.H.B.; experiments, collection, and assembly of data: Y.S.L., M.R.Y., and S.R.H.; data analysis and interpretation: C.S.L. and J.H.B.; manuscript writing and editing: A.A.S., C.S.L., and I.K.L.; critical revision: D.L. All authors have read and agreed to the published version of the manuscript.

Corresponding author

Correspondence to Chul Seung Lee.

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Ethics approval

This study was approved by St. Mary’s Hospital Research Ethics Board (KC17TESI0796) and waived the requirement for informed consent.

Conflict of interest

The authors declare no competing interests.

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Al-Sawat, A., Bea, J.H., Han, SR. et al. Use of ascitic CEA levels as a predictive value for distant metastasis in high-risk stage II and III colorectal cancer. Int J Colorectal Dis 37, 365–372 (2022). https://doi.org/10.1007/s00384-021-04070-x

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  • DOI: https://doi.org/10.1007/s00384-021-04070-x

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