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Clinical utility of the carcinoembryonic antigen level in patients with stage III colon cancer after surgery and adjuvant chemotherapy

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Abstract

Purpose

The association between perioperative and post-adjuvant carcinoembryonic antigen (CEA) levels and recurrence and prognosis remains unclear. We aimed to evaluate whether perioperative CEA levels are an integral component of the assessment of recurrence and prognosis of patients with stage III colon cancer (CC).

Methods

This retrospective study was conducted at the Cancer Institute Hospital of the Japanese Foundation for Cancer Research from 2005 to 2013. We enrolled patients with stage III CC who underwent complete resection of a primary tumor and received adjuvant chemotherapy. We analyzed the association between perioperative and post-adjuvant CEA levels and recurrence-free survival (RFS) and overall survival (OS).

Results

A total of 564 consecutive patients were included in the analysis. The RFS and OS of patients with high postoperative CEA levels were significantly worse than those of patients with normal postoperative CEA levels. In the multivariate analysis, high postoperative CEA levels were associated with shorter RFS and OS. The number of risk factors, postoperative CEA levels, and T/N-stage all had a cumulative effect on RFS and OS.

Conclusions

High postoperative CEA levels and the number of risk factors are associated with recurrence and worse prognosis for patients with stage III CC.

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Acknowledgements

We thank all the patients who participated in this study, their families, and all investigators. We also thank Ms. Hitomi Hannan, Ms. Yukie Naito, and Ms. Yuki Horiike for data management.

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Authors and Affiliations

  1. Department of Gastroenterological Chemotherapy, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan

    Shohei Udagawa, Hiroki Osumi, Akira Ooki, Takeru Wakatsuki, Kensei Yamaguchi & Eiji Shinozaki

  2. Department of Gastroenterological Surgery, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan

    Ryotaro Kozuki, Toshiki Mukai, Tomohiro Yamaguchi, Takashi Akiyoshi & Yosuke Fukunaga

  3. Department of Clinical Planning and Strategy, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, 135-8550, Japan

    Nozomi Kurihara

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  1. Shohei Udagawa
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Correspondence to Eiji Shinozaki.

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Conflicts of interest

Kensei Yamagushi received honoraria from Taiho Pharmaceutical Co., Daiichi Sankyo Co., Eli Lilly, Japan K.K., Ono Pharmaceutical Co., and Bristol-Myers Squibb Co. Kensei Yamagushi received funding from Taiho Pharmaceutical Co. Eiji Shinozaki received honoraria from Chugai Pharmaceutical Co. and Yakult Honsha Co. Shohei Udagawa, Hiroki Osumi, Ryotaro Kozuki, Akira Ooki, Takeru Wakatsuki, Nozomi Kurihara, Toshiki Mukai, Tomohiro Yamaguchi, Takashi Akiyoshi, and Yosuke Fukunaga have no conflicts of interest to declare.

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Udagawa, S., Osumi, H., Kozuki, R. et al. Clinical utility of the carcinoembryonic antigen level in patients with stage III colon cancer after surgery and adjuvant chemotherapy. Surg Today (2023). https://doi.org/10.1007/s00595-023-02779-6

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