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Issue Date: 19-Jan-2016
Authors: Cavallaro, Mario Pierpaolo
Title: Pre-operative determination of Carcinoembryonic Antigen (p-CEA) as an independent prognostic factor of Disease Free Survival (DFS) in patients treated for colorectal carcinoma
Abstract: OBJECTIVE: To evaluate whether, in a sample of patients radically treated for colorectal carcinoma, the pre-operative determination of the carcinoembryonic antigen (p-CEA) may have a prognostic value and constitute an independent risk factor in relation to disease free survival. SUMMARY OF BACKGROUND DATA: The p-CEA seems to be related both to the staging of colorectal neoplasia and to the patient's prognosis although this, to date, has not been conclusively demonstrated and is still a matter of intense debate in the scientific community. METHODS: This is a retrospective analysis of prospectively collected data. 395 patients were radically treated for colorectal carcinoma. The pre-operative CEA (p-CEA) was statistically compared to the AJCC 2010 staging, the T and N parameters, and grading. All parameters recorded in our database were tested for an association with disease-free survival (DFS). Only factors significantly associated (p<0.05) with the DFS were used to build multivariate stepwise forward logistic regression models to establish their independent predictors. RESULTS: A statistically significant relationship was found between p-CEA and tumor staging (p <0.001), T parameter (p <0.001) and N parameter (p = 0.006). In a multivariate analysis, the independent prognostic factors found were: p-CEA, stages N1 and N2 according to AJCC, and G3 grading (grade). A statistically significant difference (p <0.001) was evident between the DFS of patients with normal and high p-CEA levels. CONCLUSIONS: P-CEA makes a pre-operative selection possible of those patients for whom it is likely to be able to predict a more advanced staging.
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