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Normalization of CEA Levels Post-Neoadjuvant Therapy is a Strong Predictor of Pathologic Complete Response in Rectal Cancer

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Recent attention has been focused on the relationship between carcinoembryonic antigen (CEA) and pathological complete response (pCR), without consensus regarding its predictive value. This study aims to examine the association between CEA and pCR.

Methods

We conducted a retrospective review of a prospectively maintained database of all patients who underwent primary rectal cancer resection after neo-adjuvant chemoradiotherapy (nCRT). Patients were divided into two groups, pCR or no-pCR, based on final pathology. CEA levels were measured at the initial visit with the surgeon/oncologist and post-completion of nCRT.

Results

One hundred and forty-one patients underwent primary rectal cancer resections after nCRT. Nineteen patients (13.5 %) achieved pCR, while 122 (86.5 %) had no-pCR. Pre-nCRT CEA levels were not significantly different between groups (2.75 vs 4.5 μg/L, p = 0.65). However, post-nCRT CEA levels were significantly lower in patients with pCR (1.7 vs 2.4 μg/L, p < 0.01). On multivariate logistic regression analyses, low post-nCRT CEA level was an independent predictor of pCR (OR 1.74, CI 1.06, 3.81) and normalization of CEA from an initially elevated level was a highly significant predictor of pCR (OR 64.8, CI 2.53, 18,371).

Conclusion

Low post-nCRT CEA is an independent predictor of pCR, and normalization of CEA post-nCRT is a strong predictor of pCR.

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Acknowledgments

We thank Ms. Marie Demian, MSc, for her editorial services.

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Authors and Affiliations

  1. Division of Colorectal Surgery, Jewish General Hospital, Montreal, QC, Canada

    Ariella Kleiman, Ahmed Al-Khamis, Ali Farsi, Philip H. Gordon, Carol-Ann Vasilevsky, Nancy Morin, Julio Faria, Gabriela Ghitulescu & Marylise Boutros

  2. Department of Statistics and Epidemiology, Jewish General Hospital, Montreal, QC, Canada

    Abbas Kezouh

  3. Department of Radiation Oncology, Jewish General Hospital, Montreal, QC, Canada

    Te Vuong

  4. 3755 Cote Ste. Catherine, Montreal, QC, H3T 1E2, Canada

    Marylise Boutros

Authors
  1. Ariella Kleiman
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  2. Ahmed Al-Khamis
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  3. Ali Farsi
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  4. Abbas Kezouh
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  5. Te Vuong
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  6. Philip H. Gordon
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Corresponding author

Correspondence to Marylise Boutros.

Additional information

The data in this paper was presented at a Society for Surgery of the Alimentary Tract Quick Shot Presentation at Digestive Disease Week (May 2014, Chicago, IL).

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Kleiman, A., Al-Khamis, A., Farsi, A. et al. Normalization of CEA Levels Post-Neoadjuvant Therapy is a Strong Predictor of Pathologic Complete Response in Rectal Cancer. J Gastrointest Surg 19, 1106–1112 (2015). https://doi.org/10.1007/s11605-015-2814-3

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  • DOI: https://doi.org/10.1007/s11605-015-2814-3

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