Prognostic impact of CEA levels in rectal cancer patients who had received neoadjuvant chemoradiotherapy

Joo, Jung Il; Lim, Sangwoo; Oh, Bo Young

doi:10.3393/ac.2020.11.27

Cited by 5 publications

(4 citation statements)

References 33 publications

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“…Several clinicopathological and molecular features has been associated with a prognostic and/or predictive value in RC such us the mucinous histology (21,22), the unresponsiveness associated with mismatch repair-deficient tumors (23), loss of CDX2 expression (24), elevated pretreatment CEA levels (25), high serum inflammation markers (26,27), and the association between a low CD3 and CD8 tumor-infiltrating lymphocytes density in the pretreatment biopsies and minimal regression to CRT (28). Tumor tissue-based molecular predictors of response to nCRT in LARC patients have been extensively studied.…”

Section: Introductionmentioning

confidence: 99%

Prognostic Impact of An Integrative Landscape of Clinical, Immune, and Molecular Features in Non-Metastatic Rectal Cancer

Iseas¹,

Sendoya

Robbio³

et al. 2022

Front. Oncol.

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Rectal Cancer (RC) is a complex disease that involves highly variable treatment responses. Currently, there is a lack of reliable markers beyond TNM to deliver a personalized treatment in a cancer setting where the goal is a curative treatment. Here, we performed an integrated characterization of the predictive and prognostic role of clinical features, mismatch-repair deficiency markers, HER2, CDX2, PD-L1 expression, and CD3−CD8+ tumor-infiltrating lymphocytes (TILs) coupled with targeted DNA sequencing of 76 non-metastatic RC patients assigned to total mesorectal excision upfront (TME; n = 15) or neoadjuvant chemo-radiotherapy treatment (nCRT; n = 61) followed by TME. Eighty-two percent of RC cases displayed mutations affecting cancer driver genes such as TP53, APC, KRAS, ATM, and PIK3CA. Good response to nCRT treatment was observed in approximately 40% of the RC cases, and poor pathological tumor regression was significantly associated with worse disease-free survival (DFS, HR = 3.45; 95%CI = 1.14–10.4; p = 0.028). High neutrophils-platelets score (NPS) (OR = 10.52; 95%CI=1.34–82.6; p = 0.025) and KRAS mutated cases (OR = 5.49; 95%CI = 1.06–28.4; p = 0.042) were identified as independent predictive factors of poor response to nCRT treatment in a multivariate analysis. Furthermore, a Cox proportional-hazard model showed that the KRAS mutational status was an independent prognostic factor associated with higher risk of local recurrence (HR = 9.68; 95%CI = 1.01–93.2; p <0.05) and shorter DFS (HR = 2.55; 95%CI = 1.05–6.21; p <0.05), while high CEA serum levels were associated with poor DFS (HR = 2.63; 95%CI = 1.01–6.85; p <0.05). Integrated clinical and molecular-based unsupervised analysis allowed us to identify two RC prognostic groups (cluster 1 and cluster 2) associated with disease-specific OS (HR = 20.64; 95%CI = 2.63–162.2; p <0.0001), metastasis-free survival (HR = 3.67; 95%CI = 1.22–11; p = 0.012), local recurrence-free survival (HR = 3.34; 95%CI = 0.96–11.6; p = 0.043) and worse DFS (HR = 2.68; 95%CI = 1.18–6.06; p = 0.012). The worst prognosis cluster 2 was enriched by stage III high-risk clinical tumors, poor responders to nCRT, with low TILs density and high frequency of KRAS and TP53 mutated cases compared with the best prognosis cluster 1 (p <0.05). Overall, this study provides a comprehensive and integrated characterization of non-metastatic RC cases as a new insight to deliver a personalized therapeutic approach.

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Section: Introductionmentioning

confidence: 99%

Prognostic Impact of An Integrative Landscape of Clinical, Immune, and Molecular Features in Non-Metastatic Rectal Cancer

Iseas¹,

Sendoya

Robbio³

et al. 2022

Front. Oncol.

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“…Due to the role of inflammation in cancer patients, various inflammation-related biomarkers have been utilized to predict patient prognosis [6][7][8][9]. It is known that changes in carcinoembryonic antigen (CEA) levels have been used to assess cancer progression and recurrence [10,11]. However, neutrophillymphocyte ratio (NLR) [12], platelet-lymphocyte ratio (PLR), and lymphocyte-monocyte ratio (LMR) using systemic inflammatory markers before surgery have demonstrated usefulness in predicting clinical and oncologic outcomes after CRC surgeries.…”

Section: Introductionmentioning

confidence: 99%

Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer

Park,

Woo,

Hong

et al. 2023

Cancers

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Background: The Naples prognostic score (NPS) is a scoring system that reflects a patient’s systemic inflammatory and nutritional status. This study aimed to evaluate whether postoperative NPS is effective in assessing the prognosis of stage II–III colorectal cancer (CRC) patients compared with preoperative NPS. Methods: Between 2005 and 2012, a total of 164 patients diagnosed with stage II–III CRC, who underwent curative resection followed by adjuvant chemotherapy, were divided into two groups: Group 0–1 (NPS = 0–2) and Group 2 (NPS = 3 or 4). Preoperative NPS was calculated based on the results before surgeries, and postoperative NPS was assessed using the results obtained before adjuvant chemotherapy. Results: The overall survival of Group 0–1 was higher than that of Group 2 in both pre- and postoperative NPS assessments. According to the ROC curve analysis, the Area Under the Curve (AUC) ratio for postoperative NPS was 0.64, compared with 0.57 for preoperative NPS, 0.52 for the preoperative neutrophil–lymphocyte ratio (p = 0.032), and 0.51 for the preoperative platelet–lymphocyte ratio (p = 0.027). Conclusions: Postoperative NPS is effective in predicting the prognosis of stage II–III CRC patients who underwent curative resection followed by adjuvant chemotherapy. The use of NPS could be beneficial in evaluating the prognosis of CRC patients after surgeries.

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“…Biomarkers are quantifiable and measurable indicators that reflect normal biological processes, pathological conditions, or responses to therapeutic interventions. Biomarkers serve as diagnostic tools that provide early disease detection and act as prognostic markers to offer insights into disease progression and potential outcomes [9][10][11][12]. Inflammatory response markers, which are among the most easily measurable biomarkers, reflect the body's immune response and provide insights into the tumor microenvironment and its impact on the prognosis of CRC.…”

Section: Introductionmentioning

confidence: 99%

Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis

Kim,

Son,

2023

Ewha Med J

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Colorectal cancer (CRC) is a globally prevalent and challenging malignancy. Accurate prognosis prediction is essential for optimizing patient care. This comprehensive review discusses the intricate relationships between inflammatory response markers and CRC prognosis. Inflammatory response markers have gained prominence as a prognostic tool. Elevations in the preoperative neutrophillymphocyte ratio, platelet-lymphocyte ratio, and C-reactive protein-albumin ratio predict a poor prognosis for patients with CRC. A decreased lymphocyte-monocyte ratio is also a poor prognostic factor. A high Glasgow prognostic score and a high modified Glasgow prognostic score are associated with adverse outcomes, including reduced survival. While significant progress has been made, challenges remain in standardizing the clinical application of these inflammatory response markers. Prospective research and further investigations are warranted to refine the prognostic models. Enhanced understanding and utilization of these inflammatory response markers will help advance personalized treatment strategies, refine surveillance protocols, and improve the management of CRC.

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Prognostic impact of CEA levels in rectal cancer patients who had received neoadjuvant chemoradiotherapy

Cited by 5 publications

References 33 publications

Prognostic Impact of An Integrative Landscape of Clinical, Immune, and Molecular Features in Non-Metastatic Rectal Cancer

Prognostic Impact of An Integrative Landscape of Clinical, Immune, and Molecular Features in Non-Metastatic Rectal Cancer

Impact of Postoperative Naples Prognostic Score to Predict Survival in Patients with Stage II–III Colorectal Cancer

Inflammatory Response Markers as Predictors of Colorectal Cancer Prognosis

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