Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA

Du, Fenqi; Liu, Yu-Peng; Zhang, Qiuju; Yuan, Chao; Song, Wen-Jie; Xia, Tianyi; Guo, Jun; Wang, Handong; Xiufeng, Jiang; Bai, Junge; Chen, Jia; Hua, Xing; Yien, Li; Bai, Xue‐Feng; Liu, Yanlong

doi:10.3389/fonc.2021.758509

Cited by 13 publications

(9 citation statements)

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“…Serum carcinoembryonic antigen (CEA) is one of the established biomarkers for diagnosis, monitoring the recurrence and metastasis and the evaluation of chemotherapy in CRC [ 35 , 36 ]. Recently, the prognostic impacts of CEA have been evaluated by using ROC curves and reported that post-operative CEA (AUC = 0.686, 95% CI = 0.657–0.714) was better than pre-operative CEA (AUC = 0.621, 95% CI = 0.592–0.650) in stage II CRC [ 35 ]. In the present study, the ROC curve revealed that AUC of SPATA18 was 0.595 (95% CI = 0.50–0.69; Figure 2 a).…”

Section: Discussionmentioning

confidence: 99%

SPATA18 Expression Predicts Favorable Clinical Outcome in Colorectal Cancer

Sugimura-Nagata

Koshino

Nagao

et al. 2022

IJMS

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Dysregulation of mitochondrial quality control has been reported to be associated with cancer and degenerative diseases. SPATA18 (spermatogenesis-associated 18, also known as Mieap) encodes a p53-inducible protein that can induce lysosome-like organelles within mitochondria that eliminate oxidized mitochondrial proteins and has tumor suppressor functions in mitochondrial quality control. In the present study, 268 primary colorectal cancers (CRCs) were evaluated immunohistochemically for SPATA18 expression to assess its predictive utility and its association with cellular proliferation activity. Furthermore, the association with p53 immunoreactivity, a surrogate marker for TP53 mutation, was analyzed. Non-neoplastic colonic mucosa showed cytoplasmic SPATA18 expression. Seventy-two percent of the lesions (193/268) displayed high SPATA18 expression in the cytoplasm of CRC cells. Univariate analyses revealed significant associations between SPATA18 expression and tumor size (p < 0.0001), histological differentiation (p = 0.0017), and lymph node metastasis (p = 0.00039). The log-rank test revealed that patients with SPATA18-high CRCs had significantly better survival than SPATA18-low patients (p < 0.0001). Multivariate Cox hazards regression analysis identified tubular-forming histology (hazard ratio [HR] = 0.25), age < 70 years (HR = 0.50), and SPATA18-high (HR = 0.55) as potential favorable factors. Lymph node metastasis (HR = 1.98) and peritoneal metastasis (HR = 5.45) were cited as potential independent risk factors. Cellular proliferation activity was significantly higher in SPATA18-high tumors. However, no significant correlation was detected between SPATA18 expression and p53 immunoreactivity or KRAS/BRAF mutation status. On the basis of our observations, SPATA18 immunohistochemistry can be used in the prognostication of CRC patients.

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Section: Discussionmentioning

confidence: 99%

SPATA18 Expression Predicts Favorable Clinical Outcome in Colorectal Cancer

Sugimura-Nagata

Koshino

Nagao

et al. 2022

IJMS

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“…Several studies have reported that a high-normal preoperative CEA level was an independent prognosticator for poor DFS in CRC compared with the low-normal group. 33,34 However, Fenqi et al 35 showed that when the early postoperative CEA level was positive (>3.66 ng/mL) in patients with stage II CRC, the preoperative CEA level showed no significant effect on the patient’s prognosis.…”

Section: Discussionmentioning

confidence: 99%

Tumor Marker Trajectories and Survival Analysis in Patients with Normal Carcinoembryonic Antigen Ranges After Colorectal Cancer Resection

Chern,

Hsu,

Hsu

et al. 2023

Diseases of the Colon &Amp; Rectum

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BACKGROUND: Evidence regarding postoperative CEA for predicting long-term outcomes of colorectal cancer remains controversial, especially in patients with normal postoperative CEA. OBJECTIVE: To investigate the risk difference among different postoperative CEA trajectories in patients with normal postoperative CEA after curative colorectal cancer resection. DESIGN: This cohort study was conducted at a comprehensive cancer center and included data retrieved from a prospectively collected database between January 2006 and December 2018. SETTINGS: Retrospective cohort study. PATIENTS: Patients with colorectal cancer who underwent surgery for primary stage I–III colorectal adenocarcinoma were included. Patients with postoperative CEA >5 ng/mL were excluded. INTERVENTIONS: Standard curative radical resection was performed. MAIN OUTCOME MEASURES: Ten-year overall survival and disease-free survival were analyzed. RESULTS: The study population (n = 8156) was categorized into 6 trajectories, including persistently-ultralow (n = 2351), persistent-low (n = 2474), gradually-decrease (n = 401), persistent-medium (n = 1727), slightly-increase (n = 909), and around-upper-limit (n = 394). The median follow-up time was 7.8 years, and the median timeframe in which CEA was measured to determine trajectory was 2.6 years. The persistent-ultralow group had the highest 10-year overall survival (85.1%) and disease-free survival (82.7%). The around-upper-limit group had the lowest 10-year overall survival (55.5%) and disease-free survival (53.4%). The adjusted hazard ratio trend was comparable to crude hazard ratio of the persistent-ultralow group. Consequently, the higher initial serum CEA groups had higher hazard ratios of overall survival and disease-free survival. The adjusted hazard ratios of overall survival/disease-free survival were 2.96/2.66 (95% confidence interval: 2.39–3.66/2.18–3.69) for the around-upper-limit groups. LIMITATIONS: The study was limited by its retrospective design. CONCLUSIONS: The postoperative serum CEA trajectory is an independent factor associated with long-term outcomes. Although CEA levels were all within normal range, higher levels of postoperative serum CEA trajectory correlated with worse long-term oncological outcomes..

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“…By multivariate analyses, elevated baseline level of CA19-9, advanced pN stage and harvested lymph nodes less than 12 were found to be independently associated with DM, and the first two were also independent prognostic factors for DFS, whereas advanced pN stage was associated with poor CSS. It is known that many tumor markers, such as CEA and CA19-9, are useful prognostic indicator to predict relapse and survival in rectal cancer patients ( 23 – 25 ). In addition to the association between baseline CA19-9 level and DM after laparoscopic resection of rectal cancer, our study showed that elevated baseline level of CEA was an independent risk factor for lung metastasis and predicted inferior DFS.…”

Section: Discussionmentioning

confidence: 99%

Patterns and predictors of recurrence after laparoscopic resection of rectal cancer

Yang

Chen²,

Wu³

et al. 2022

Front. Oncol.

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PurposeThis study was designed to evaluate the patterns and predictors of recurrence in patients who underwent laparoscopic resection of rectal cancer.MethodsPatients with rectal cancer receiving laparoscopic resection between April 2009 and March 2016 were retrospectively analyzed. The association of recurrence with clinicopathological characteristics was evaluated using multivariate analyses.ResultsA total of 405 consecutive patients were included in our study. Within a median follow-up time of 62 months, 77 patients (19.0%) experienced disease recurrence: 10 (2.5%) had locoregional recurrence (LR), 61 (15.1%) had distant metastasis (DM), and 6 (1.5%) developed LR and DM synchronously. The lung was the most common site of metastasis. Multivariate analyses indicated that involved circumferential resection margin (CRM) was the only independent predictor for LR (OR=13.708, 95% CI 3.478-54.026, P<0.001), whereas elevated baseline level of CA19-9 (OR=3.299, 95% CI 1.461-7.449, P=0.032), advanced pN stage (OR=2.292, 95% CI 1.177-4.462, P=0.015) and harvested lymph nodes less than 12 (OR=2.418, 95% CI 1.245-4.695, P=0.009) were independently associated with DM. Patients receiving salvage surgery showed superior 3-year survival compared with palliative treatment after relapse (90.9% vs. 20.5%; P=0.017). The estimated 5-year DFS and CSS for the entire cohort was 80.2% and 83.1%, respectively.ConclusionsDM was more common than LR after laparoscopic resection of rectal cancer, and there were several clinicopathological factors related to LR and DM. Involved CRM and suboptimal lymph node yield were adverse surgery-related factors of tumor recurrence, which should be paid more attention to during the operation.

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Early Postoperative Serum Carcinoembryonic Antigen Is a Stronger Independent Prognostic Factor for Stage II Colorectal Cancer Patients Than T4 Stage and Preoperative CEA

Cited by 13 publications

References 38 publications

SPATA18 Expression Predicts Favorable Clinical Outcome in Colorectal Cancer

SPATA18 Expression Predicts Favorable Clinical Outcome in Colorectal Cancer

Tumor Marker Trajectories and Survival Analysis in Patients with Normal Carcinoembryonic Antigen Ranges After Colorectal Cancer Resection

Patterns and predictors of recurrence after laparoscopic resection of rectal cancer

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