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Adjuvant chemotherapy benefits on patients with elevated carcinoembryonic antigen in stage IIA colon cancer: a SEER-based analysis

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Objective

Indications for adjuvant chemotherapy in stage IIA (T3N0M0) colon cancer are still controversial. The purpose of this study was to evaluate the prognostic value of elevated carcinoembryonic antigen (CEA) levels for cancer-specific survival (CSS) and overall survival (OS) in patients with stage IIA colon cancer. We aimed to examine the impact of adjuvant chemotherapy on OS in stage IIA colon cancer patients with elevated CEA levels.

Methods

Patients with stage IIA colon cancer (N = 3477) diagnosed between 2010 and 2015 were identified using the Surveillance, Epidemiology, and End Results (SEER) database. Kaplan–Meier and Cox proportional hazards regression models were used to assess the prognostic effect of CEA on CSS and OS.

Results

Cox regression analysis demonstrated that CEA was an independent risk factor for CSS and OS in patients with stage IIA colon cancer (CSS: HR = 2.001, 95% CI 1.603–2.499, P < 0.001; OS: HR = 1.530, 95% CI 1.335–1.752, P < 0.001). In the subgroup with elevated CEA, patients received adjuvant chemotherapy had a better OS compared with those did not (χ2 = 10.585, p = 0.001).

Conclusion

CEA was an independent risk factor for CSS and OS in patients with stage IIA colon cancer. Patients with stage IIA colon cancer with an elevated CEA level might benefit from adjuvant chemotherapy.

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Acknowledgements

We would like to thank the SEER program for making the database available to the public.

Author information

Authors and Affiliations

  1. Department of General Surgery, Zhujiang Hospital, Southern Medical University, Haizhu District, No.253. Gongye Middle Avenue, Guangzhou, Guangdong, 510280, China

    Huabin Zhou, Songsheng Wang, Zhai Cai, Enming Qiu, Qianyun Chen, Xi Rao, Shuai Han & Zhou Li

  2. Department of General Surgery, SSL Central Hospital of Dongguan, Affiliated Dongguan Shilong People’s Hospital of Southern Medical University, Dongguan, Guangdong, 523326, China

    Huabin Zhou

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Contributions

All authors contributed to the study’s conception and design. Data collection and manuscript preparation were performed by Huabin Zhou, Songsheng Wang, and Zhai Cai. Statistical analysis and data analysis were performed by Enming Qiu, Qianyun Chen, and Xi Rao. The first draft of the manuscript was written by Huabin Zhou and reviewed by Zhou Li and Shuai Han. All authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Zhou Li.

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Communicated by Christoph-Thomas Germer

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Huabin Zhou and Songsheng Wang are the first co-authors.

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Zhou, H., Wang, S., Cai, Z. et al. Adjuvant chemotherapy benefits on patients with elevated carcinoembryonic antigen in stage IIA colon cancer: a SEER-based analysis. Int J Colorectal Dis 37, 2481–2489 (2022). https://doi.org/10.1007/s00384-022-04278-5

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