The Role of Carcinoembriogenic Antigen in Predicting Response and Survival to Neoadjuvant Chemoradiotherapy for Distal Rectal Cancer

Abstract

A postchemoradiotherapy CEA level <5 ng/ml is a favorable prognostic factor for rectal cancer and is associated with increased rates of earlier disease staging and complete tumor regression. Postchemoradiotherapy CEA levels may be useful in decision making for patients who may be candidates for alterative treatment strategies.

Desenlaces del manejo no quirúrgico posterior a neoadyuvancia del cáncer localmente avanzado de recto

“…Habr-Gama, fue la primera cirujano en determinar prospectivamente, el manejo no quirúrgico de pacientes con cáncer localmente avanzado de recto, después de determinarse respuesta clínica completa posterior a la neoadyuvancia 19,[23][24][35][36][37][38][39] .…”

“…Aunque la sensibilidad en fumadores es equívoca 39 , se ha considerado como factor pronóstico de sobrevida en algunos estudios. También se ha sugerido, el aumento de intensidad de la quimioterapia adyuvante, cuando los valores de ACE preneoadyuvancia son marcadamente elevados 40 .…”

Prediction of response to preoperative chemoradiotherapy in patients with locally advanced rectal cancer

“…predictive values, the results were controversial. Perez et al didn′t find a correlation between initial CEA-pre level and pCR (37).…”

“…Perez et al reported that a CEA-post level < 5 ng/mL was associated with increased rates of clinical CR and pCR (37). CEA-post with a different cut-off value of 2.7 ng/mL was also proved to be an independent predictor of good tumor regression (p = 0.001) (38).…”

“…Compared with other potential predictive markers, measurement of serum CEA levels are inexpensive, standardized, widely used and easily performed (33). In recent years, many studies have focused on the predictive value of CEA levels in patients with rectal cancer receiving pre-CRT (Table 3) (34)(35)(36)(37)(38)(39)(40). Most studies showed low pre-CRT CEA (CEA-pre) levels with different cut-off values associated with good tumor response or pCR (34)(35)(36), but concerning the CEA-pre Low CEA-pre was significantly associated with pCR.…”