수술 전 화학방사선요법을 시행한 직장암 환자에서 치료 전 혈청 CEA의 예후적 가치
Pretreatment Serum CEA as a Prognostic Factor for Rectal Cancer Treated with Preoperative Chemoradiotherapy
김규형, 김대용, 장희진, 최효성, 박지원, 오재환, 박성찬, 백지연, 김선영,
소속 상세정보
김규형 ( Kim Kyu-Hyung )
서울대학교 의과대학 외과학교실
김대용 ( Kim Dae-Yong )
국립암센터 대장암센터
장희진 ( Chang Hee-Jin )
국립암센터 대장암센터
최효성 ( Choi Hyo-Seong )
국립암센터 대장암센터
박지원 ( Park Ji-Won )
국립암센터 대장암센터
오재환 ( Oh Jae-Hwan )
국립암센터 대장암센터
박성찬 ( Park Sung-Chan )
국립암센터 대장암센터
백지연 ( Baek Ji-Yeon )
국립암센터 대장암센터
김선영 ( Kim Sun-Young )
국립암센터 대장암센터
KMID : 0356720100260010039
Abstract
Purpose: Preoperative serum carcinoembryonic antigen (s-CEA) is well known to be a prognostic factor in patients with colorectal cancer. However, the prognostic effect of s-CEA in patients with rectal cancer treated with preoperative chemoradiotherapy (CRT) has not been well studied. The aim of this study is to evaluate the prognostic value of pretreatment s-CEA for rectal cancer treated with preoperative CRT.
Methods: Preoperative serum carcinoembryonic antigen (s-CEA) is well known to be a prognostic factor in patients with colorectal cancer. However, the prognostic effect of s-CEA in patients with rectal cancer treated with preoperative chemoradiotherapy (CRT) has not been well studied. The aim of this study is to evaluate the prognostic value of pretreatment s-CEA for rectal cancer treated with preoperative CRT.
Results: The three-year disease-free survival rates of the CEA ≤10 ng/mL group and the CEA >10 ng/mL group were 80.4% and 67.3%, respectively (P=0.002). Multivariate analysis revealed the following independent risk factor for recurrence: pretreatment CEA >10 ng/mL (hazard ratio [HR] 1.616; 95% confidence interval [CI], 1.007 to 2.594; P=0.047), positive lymph node status (HR, 2.580; 95% CI, 1.625 to 4.094; P<0.001), and positive circumferential resection margin (HR, 1.889; 95% CI, 1.035 to 3.446; P=0.038).
Conclusions: Pretreatment s-CEA (cutoff value 10 ng/mL) may be a prognostic factor for disease-free survival in rectal cancer patients treated with preoperative CRT and surgery.
키워드
직장암; 암배아성항원; 화학방사선요법
Rectal cancer; CEA; Chemoradiotherapy
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