PMID- 33260810
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201226
IS  - 2077-0383 (Print)
IS  - 2077-0383 (Electronic)
IS  - 2077-0383 (Linking)
VI  - 9
IP  - 12
DP  - 2020 Nov 27
TI  - Association between Primary Perioperative CEA Ratio, Tumor Site, and Overall 
      Survival in Patients with Colorectal Cancer.
LID - 10.3390/jcm9123848 [doi]
LID - 3848
AB  - There are differences in the incidence, clinical presentation, molecular 
      pathogenesis, and outcome of colorectal cancer (CRC) based on tumor location. 
      Emerging research suggests that the perioperative carcinoembryonic antigen (CEA) 
      ratio (post-op/pre-op CEA) is a prognostic factor for CRC patients. We aimed to 
      determine the association between CEA ratio, tumor location, and overall survival 
      (OS) among patients with CRC. We analyzed 427 patients who underwent resection 
      for CRC at the University of Kansas Medical Center. After excluding those without 
      pre- or post-operative CEA data, 207 patients were classified as either high 
      (>/=0.5) or low (<0.5) ratio. Primary outcomes were as follows: (1) OS stratified 
      by CEA ratio; (2) OS stratified by tumor location; (3) OS stratified by tumor 
      location among those with CEA elevation > 5 ng/mL at the time of recurrence. The 
      Kaplan-Meier method was used to estimate survival rates. The median age was 62 
      years (inter-quartile range 51-71), 55% were male, 41% were smokers, 71% had 
      left-sided tumors, the median pre-operative CEA was 3.1 ng/mL (inter-quartile 
      range (IQR) 1.5-9.7), and 57% had a CEA ratio >/=0.5. The OS rates were 65.1% and 
      86.3% in patients with high versus low CEA ratios, respectively (log-rank p-value 
      = 0.045). The OS rates were 64.4% and 77.3% in patients with right-sided vs. 
      left-sided tumors, respectively (log-rank p-value = 0.5). Among patients with CEA 
      levels greater than 5 at the time of recurrence, the OS rates were 42.9% and 
      43.4% in patients with right-sided vs. left-sided tumors, respectively (log-rank 
      p-value = 0.7). There was a significantly higher survival among patients with low 
      CEA ratios than among those with high CEA ratios. There was no difference in OS 
      between left- versus right-sided tumors. Among patients with CEA elevation > 5 
      ng/mL at the time of recurrence, there was no difference in OS between left 
      versus right-sided tumors. These findings warrant validation in a larger cohort 
      as our sample size was limited.
FAU - Odeny, Thomas A
AU  - Odeny TA
AD  - Department of Medicine, University of Missouri-Kansas City, Kansas City, MO 
      64108, USA.
FAU - Farha, Nicole
AU  - Farha N
AD  - Department of Medicine, University of Kansas Medical School, Kansas City, KS 
      66160, USA.
FAU - Hildebrandand, Hannah
AU  - Hildebrandand H
AD  - Department of Medicine, University of Kansas Medical School, Kansas City, KS 
      66160, USA.
FAU - Allen, Jessica
AU  - Allen J
AD  - Department of Medicine, University of Kansas Medical School, Kansas City, KS 
      66160, USA.
FAU - Vazquez, Wilfred
AU  - Vazquez W
AD  - Department of Medicine, University of Kansas Medical School, Kansas City, KS 
      66160, USA.
FAU - Martinez, Maximillian
AU  - Martinez M
AD  - Department of Medicine, University of Kansas Medical School, Kansas City, KS 
      66160, USA.
FAU - Paluri, Ravi Kumar
AU  - Paluri RK
AD  - Department of Medicine, Wake Forest School of Medicine, Winston-Salem, NC 27101, 
      USA.
FAU - Kasi, Anup
AU  - Kasi A
AD  - Department of Medicine, Division of Medical Oncology, University of Kansas Cancer 
      Center, 2650 Shawnee Mission Pkwy, Fairway, KS 66205, USA.
LA  - eng
PT  - Journal Article
DEP - 20201127
PL  - Switzerland
TA  - J Clin Med
JT  - Journal of clinical medicine
JID - 101606588
PMC - PMC7760538
OTO - NOTNLM
OT  - CEA
OT  - CEA ratio
OT  - carcinoembryonic antigen
OT  - colorectal tumor location
COIS- The authors declare no conflict of interest.
EDAT- 2020/12/03 06:00
MHDA- 2020/12/03 06:01
PMCR- 2020/11/27
CRDT- 2020/12/02 01:02
PHST- 2020/10/08 00:00 [received]
PHST- 2020/11/11 00:00 [revised]
PHST- 2020/11/19 00:00 [accepted]
PHST- 2020/12/02 01:02 [entrez]
PHST- 2020/12/03 06:00 [pubmed]
PHST- 2020/12/03 06:01 [medline]
PHST- 2020/11/27 00:00 [pmc-release]
AID - jcm9123848 [pii]
AID - jcm-09-03848 [pii]
AID - 10.3390/jcm9123848 [doi]
PST - epublish
SO  - J Clin Med. 2020 Nov 27;9(12):3848. doi: 10.3390/jcm9123848.