Year 2021 / Volume 113 / Number 6
Original
Can we optimize CEA as a response marker in rectal cancer?

423-428

DOI: 10.17235/reed.2020.7321/2020

Tânia Gago, Paulo Caldeira, Ana Catarina Cunha, Pedro Campelo, Horácio Guerreiro,

Abstract
Background and aim: carcinoembryonic antigen (CEA) is a biomarker commonly used in colorectal cancer. However, its prognostic value is still controversial. Recent studies demonstrate that CEA produced locally by tumor cells has a higher prognostic value compared to serum CEA. This study aimed to determine whether there was an association between the CEA/tumor size ratio (CEA/ExT) and the pathological tumor response in patients with rectal adenocarcinoma (ADC), who underwent neoadjuvant chemoradiotherapy (N-CRT), followed by surgical tumor resection. Methods: a retrospective study was performed of rectal ADC patients who underwent N-CRT followed by curative surgery between March/2012 and October/2017. CEA and tumor extension for pre-treatment CEA/ExT calculation and the pathological response in the surgical specimen after treatment were analyzed. Results: eighty-nine patients were included, 60.7 % were male and the mean age was 63.8 ± 10.42. There was a good response to N-CRT in 41.6 % of the patients, tumor downstaging occurred in 83.1 % and a complete pathological response in 23.6 % of cases. The average CEA/ExT was 2.01 ng/ml/cm. In the univariate analysis, higher CEA/ExT values were related to a lower frequency of pathological response (p = 0.04) and to a lower frequency of tumor downstaging (p = 0.02). In the multivariate analysis, CEA/ExT was independently related to tumor downstaging (OR: 0.72; 95 % IC: 0.53-0.98, p-0.036). Conclusions: lower pre-treatment CEA/ExT values seem to be associated with tumor downstaging and this parameter may be a promising predictor of a more favorable response in patients with rectal ADC undergoing treatment with N-CRT.
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Gago T, Caldeira P, Cunha A, Campelo P, Guerreiro H. Can we optimize CEA as a response marker in rectal cancer?. 7321/2020


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Publication history

Received: 07/06/2020

Accepted: 09/07/2020

Online First: 24/11/2020

Published: 04/06/2021

Article revision time: 27 days

Article Online First time: 170 days

Article editing time: 362 days


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