Elevated CEA Levels and Low Distance of the Tumor from the Anal Verge are Predictors of Incomplete Response to Chemoradiation in Patients with Rectal Cancer
| Autor: | Luigi Marongiu, Carla Margiani, Ivana Maria Francesca Cocco, Giuseppe Casula, Angelo Restivo, Luigi Zorcolo, Romina Manunza |
|---|---|
| Rok vydání: | 2012 |
| Předmět: |
Male
medicine.medical_specialty Colorectal cancer medicine.medical_treatment Anal Canal Gastroenterology Carcinoembryonic antigen Internal medicine Biomarkers Tumor medicine Humans Prospective Studies Stage (cooking) Prospective cohort study Survival rate Neoadjuvant therapy Aged Neoplasm Staging biology Rectal Neoplasms business.industry Remission Induction Chemoradiotherapy Middle Aged Anal canal Prognosis medicine.disease Neoadjuvant Therapy Carcinoembryonic Antigen Survival Rate medicine.anatomical_structure Oncology biology.protein Female Surgery business Follow-Up Studies |
| Zdroj: | Annals of Surgical Oncology. 20:864-871 |
| ISSN: | 1534-4681 1068-9265 |
| DOI: | 10.1245/s10434-012-2669-8 |
| Popis: | The objective of this study was to evaluate pretreatment clinical parameters as predictive factors for complete pathological response after long-term chemoradiotherapy (RCT) for rectal cancer. Tumor downstaging after RCT for rectal cancer can be obtained in half of cases, whereas a complete pathological response (CPR) is reported to range between 15 and 30%. It is not possible to foresee before therapies who will respond.Patients with stage II-III rectal cancer that had undergone RCT and rectal resection between January 1995 and October 2010 were considered. Patients were divided in those who achieved a CPR, "CR" group, and those who did not achieve a CPR, "NCR" group. Univariate and multivariate analyses between groups were performed considering the clinical parameters: gender, age, ASA score, preoperative hematic CEA, tumor grading; distance of the tumor from the anal verge, maximum tumor diameter, TNM stage, and neoadjuvant treatment details.Among 260 patients, 43 (16.5%) achieved a CPR. The two groups resulted homogeneous for age, sex, pretreatment status, and tumor stage. A CEA5 ng/dl and distance from anal verge5 cm were correlated with CPR at multivariate analysis. Patients with both these conditions presented a significantly higher CPR rate (30.6%) as well as improved 5-year survival. CPR was also correlated with improved survival.Very low tumors with a high serum CEA are very unlikely to reach a CPR. The predictive value of these easily available clinical factors should not be underestimated, and better therapeutic strategies for these tumors are needed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink