Annals of Surgical Oncology

, Volume 13, Issue 5, pp 645–650 | Cite as

Prognostic Effect of Perioperative Change of Serum Carcinoembryonic Antigen Level: A Useful Tool for Detection of Systemic Recurrence in Rectal Cancer

  • Yoon-Ah Park
  • Kang Young Lee
  • Nam Kyu Kim
  • Seung Hyuk Baik
  • Seung Kook Sohn
  • Chang Whan Cho



The prognosis of patients even with the same stage of rectal cancer varies widely. We analyzed the capability of perioperative change of serum carcinoembryonic antigen (CEA) level for predicting recurrence and survival in rectal cancer patients.


We reviewed 631 patients who underwent potentially curative resection for stage II or III rectal cancer. Patients were categorized into three groups according to their serum CEA concentrations on the seventh day before and on the seventh day after surgery: group A, normal CEA level (≤5 ng/mL) in both periods; group B, increased preoperative and normal postoperative CEA; and group C, continuously increased CEA in both periods. The prognostic relevance of the CEA group was investigated by analyses of recurrence patterns and survival.


Stage III patients showed higher systemic recurrence (P = .001) and worse 5-year survival rates (P < .0001) for group C than for groups A and B. On multivariate analysis, the CEA group was a significant predictor for recurrence (P < .001; relative risk, 2.740; 95% confidence interval, 1.677–4.476) and survival (P = .001; relative risk, 2.174; 95% confidence interval, 1.556–3.308).


The perioperative serum CEA change was a useful prognostic indicator to predict for systemic recurrence and survival in stage III rectal cancer patients.


Rectal cancer Perioperative serum CEA change Recurrence Prognosis 



The authors thank Scott Butler, MD, for his editorial comments. This study was supported by Yonsei University Research Fund of 2002.


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Copyright information

© The Society of Surgical Oncology, Inc. 2006

Authors and Affiliations

  • Yoon-Ah Park
    • 1
  • Kang Young Lee
    • 1
  • Nam Kyu Kim
    • 1
  • Seung Hyuk Baik
    • 1
  • Seung Kook Sohn
    • 1
  • Chang Whan Cho
    • 1
  1. 1.Department of SurgeryYonsei University College of MedicineSeodaemun-kuKorea

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