Use of ascitic CEA levels as a predictive value for distant metastasis in high-risk stage II and III colorectal cancer

Purpose This study aimed to analyze the effect of ascitic carcinoembryonic antigen (CEA) levels on the long-term oncologic outcomes of colorectal cancer (CRC) following curative treatment. Methods A total of 191 patients with stage II/III CRC were included. CEA was analyzed on the peritoneal fluid s...

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Bibliographic Details
Published in:International journal of colorectal disease 2022-02, Vol.37 (2), p.365-372
Main Authors: Al-Sawat, Abdullah, Bea, Jung Hoon, Han, Seung-Rim, Lee, Hyo Jin, Yoon, Mi Ran, Lee, Yoon Suk, Lee, Do Sang, Lee, Chul Seung, Lee, In Kyu
Format: Article
Language:English
Subjects:
Cancer
Carcinoembryonic Antigen
CEA (Oncology)
Colorectal cancer
Colorectal carcinoma
Colorectal Neoplasms
Disease-Free Survival
Gastroenterology
Hepatology
Humans
Internal Medicine
Liver
Liver Neoplasms
Medicine
Medicine & Public Health
Metastases
Metastasis
Multivariate analysis
Original Article
Patients
Peritoneal fluid
Peritoneum
Proctology
Prognosis
Retrospective Studies
Risk factors
Surgery
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Summary:Purpose This study aimed to analyze the effect of ascitic carcinoembryonic antigen (CEA) levels on the long-term oncologic outcomes of colorectal cancer (CRC) following curative treatment. Methods A total of 191 patients with stage II/III CRC were included. CEA was analyzed on the peritoneal fluid samples taken at the start of each surgery. Long-term oncologic outcomes were analyzed using known risk factors for recurrence in CRC. Result Multivariate analysis of recurrence showed that lymphatic invasion (hazards ratio (HR) 2.7, 95% confidence interval (CI) 1.1–7, p  = 0.038), vascular invasion (HR 2.8, 95% CI 1.2–6.3, p  = 0.013), mucinous cancer (HR 3.6, 95% CI 1.3–10.1, p  = 0.017), and peritoneal fluid CEA exceeding 5 ng/dl (odds ratio 3.1, 95% CI 1.2–7.7, p  = 0.017) were significant risk factors. There were 14 patients with liver metastasis, 11 of whom had high ascitic CEA levels and no peritoneal metastasis. Additionally, eight had lung metastasis, and seven of them had high ascitic CEA levels. Conclusion High ascitic CEA levels showed significantly lower disease-free survival and were significantly associated with distant metastasis in the lung and liver.
ISSN:0179-1958
1432-1262
DOI:10.1007/s00384-021-04070-x