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Prognostic value of carcinoembryonic antigen level in rectal cancer treated with neoadjuvant chemoradiotherapy

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Background

The purpose of this study was to identify clinical and pathological parameters to improve prediction of disease-free survival (DFS) and overall survival (OS) in patients treated with neoadjuvant chemoradiotherapy for rectal cancer.

Methods

Between July 1995 and May 2007, 148 patients with primary rectal adenocarcinoma received neoadjuvant chemoradiotherapy followed by mesorectal excision. Preoperative treatment included various protocols, UFT and leucovorin (28%) and oxaliplatin-based chemotherapy (72%). Clinical and pathological variables were evaluated in relation to patient outcomes.

Results

Thirteen percent of patients achieved a complete pathologic response. No response or minimal response as defined by Dworak (Tumor Regression Grade 0/1) was observed in 30 patients (20%). At a median follow-up of 37 months, the 3-year DFS and OS were 64% and 83%, respectively. Pre-treatment serum carcinoembryonic antigen (CEA) level ≤ 2.5 ng/ml was associated with higher DFS (74 vs. 53%; p = 0.018), higher complete pathologic responses (21 vs. 9%; p = 0.05), and less recurrences (24 vs. 44%; p = 0.014).

Conclusion

The data suggest that a CEA level ≤ 2.5 ng/ml might be a predictor not only of tumor response, as has been suggested before, but also of DFS. This finding could be useful in the future to predict individual risk and to develop more aggressive or alternative strategies.

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Authors and Affiliations

  1. Service of Medical Oncology, University Hospital La Paz, Madrid, Spain

    V. Moreno García, P. Cejas, M. Blanco Codesido, J. Feliu Batlle, J. de Castro Carpeño, C. Belda-Iniesta, J. Barriuso & M. González-Barón

  2. Department of Preventive Medicine, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain

    J. J. Sánchez

  3. Service of Pathology, University Hospital La Paz, Madrid, Spain

    J. Larrauri

  4. Department of Medical Oncology, Hospital Infanta Sofía, Madrid, Spain

    E. Casado

  5. Paseo de la Castellana 261, 28046, Madrid, Spain

    V. Moreno García

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  1. V. Moreno García
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  2. P. Cejas
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  3. M. Blanco Codesido
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Correspondence to V. Moreno García.

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Supported in part by Biomedical Research Foundation, University Hospital La Paz.

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Moreno García, V., Cejas, P., Blanco Codesido, M. et al. Prognostic value of carcinoembryonic antigen level in rectal cancer treated with neoadjuvant chemoradiotherapy. Int J Colorectal Dis 24, 741–748 (2009). https://doi.org/10.1007/s00384-009-0682-6

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  • DOI: https://doi.org/10.1007/s00384-009-0682-6

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