Pre‐operative carcinoembryonic antigen predicts survival following colorectal cancer surgery with curative intent

• DOI: 10.1111/ans.14723
• Publication Date: 2018-08-01T13:05:58Z
• Authors: Ashok Gunawardene; Peter Larsen; Ali Shekouh; Elizabeth Dennett
• Keywords: Adult; Aged, 80 and over; Male; Adenocarcinoma; Middle Aged; Prognosis; Disease-Free Survival; 3. Good health; Carcinoembryonic Antigen; Survival Rate; 03 medical and health sciences; 0302 clinical medicine; Preoperative Period; Biomarkers, Tumor; Humans; Female; Postoperative Period; Colorectal Neoplasms; Colectomy; Aged; Follow-Up Studies; New Zealand; Retrospective Studies

BackgroundCirculating biomarkers may be of value in providing additional prognostic information to the TNM staging system. Previous population‐level studies suggest a prognostic role for pre‐operative carcinoembryonic antigen (CEA). The purpose of this study is to verify the prognostic role of pre‐operative CEA at the individual level, in a New Zealand cohort of colorectal cancer patients.MethodsRetrospective cohort study of patients undergoing potentially curative surgery for colorectal adenocarcinoma between 2010 and 2012 at a tertiary hospital in New Zealand. One hundred and thirty‐nine patients had pre‐operative CEA data available and were included in the study. The main outcomes measured were overall survival (OS) and disease‐free survival (DFS) over a minimum of 5 years of follow up.ResultsPre‐operative CEA was requested in 138 out of 237 (58.2%) patients undergoing surgery. The median age was 71 years and median follow‐up duration 61 months. High CEA was not associated with the incidence of disease recurrence (P = 0.69). A significant difference was found between high and low CEA for OS (P = 0.09) and DFS (P = 0.04). On multi‐variate survival analysis, pre‐operative CEA was identified as an independent predictor of OS (HR 2.50, 95% CI 1.17–5.36, P = 0.02) and DFS (HR 1.78, 95% CI 1.02–3.13, P = 0.04).ConclusionWe identified pre‐operative CEA as an independent predictor of OS and DFS on an individual level. CEA offers additional prognostic value to TNM staging and should be requested routinely as part of the pre‐operative work‐up.