Prognostic significance of pre- and postoperative serum carcinoembryonic antigen levels in patients with colorectal cancer

Background: To evaluate the prognostic significance of pre- and postoperative serum carcinoembryonic antigen (CEA) levels in colorectal cancer (CRC) patients. Methods: 425 CRC patients underwent curative resection at our institution. Their pre- and postoperative serum CEA level was classified into two groups according to concentration: normal CEA (< 5.0 ng/ml) and abnormal CEA (>= 5.0 ng/ml). Results: Of all patients, abnormal pre- and postoperative serum CEA levels were observed in 181 (42.6%) and 48 (11.3%) patients, respectively. Abnormal preoperative serum CEA level was significantly correlated with the tumor located in the colon, the depth of tumor invasion, the status of lymph node metastasis, UICC stage, and the presence of postoperative relapse (p < 0.05). Concurrently, an abnormal postoperative serum CEA level was also prominently related to the above corresponding parameters (p < 0.05), except for the tumor location. Patients with a failed conversion of abnormal preoperative value to normal postoperative concentration were found to have the worst overall survival rate. Abnormal pre- and postoperative serum CEA levels were single independent predictors for survival and postoperative relapse, respectively. Conclusions: The identification of abnormal pre- and postoperative serum CEA levels may be useful in the auxiliary cancer prognosis or postoperative surveillance of CRC patients. Copyright (c) 2007 S. Karger AG, Basel.