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Lawrence, Nicola;
Hinder, Victoria;
Murray, Melissa;
Macapagal, Jerome;
Thompson, Paul;
Sharples, Katrina;
Findlay, Michael
Transient elevation in serum carcinoembryonic antigen while on adjuvant chemotherapy for colon cancer: Is this of prognostic importance?
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- Media type: E-Article
- Title: Transient elevation in serum carcinoembryonic antigen while on adjuvant chemotherapy for colon cancer: Is this of prognostic importance?
- Contributor: Lawrence, Nicola; Hinder, Victoria; Murray, Melissa; Macapagal, Jerome; Thompson, Paul; Sharples, Katrina; Findlay, Michael
- Published: Wiley, 2017
- Published in: Asia-Pacific Journal of Clinical Oncology
- Extent:
- Language: English
- DOI: 10.1111/ajco.12402
- ISSN: 1743-7555; 1743-7563
- Keywords: Oncology ; General Medicine
- Abstract: <jats:title>Abstract</jats:title><jats:sec><jats:title>Aims</jats:title><jats:p>Serum carcinoembryonic antigen (<jats:styled-content style="fixed-case">CEA</jats:styled-content>) is used to detect relapses from colon cancer following initial surgical or adjuvant treatment. There are little data on transient elevations of <jats:styled-content style="fixed-case">CEA</jats:styled-content> while receiving chemotherapy in the adjuvant setting. We aimed to review patterns of change in <jats:styled-content style="fixed-case">CEA</jats:styled-content> levels while receiving adjuvant chemotherapy and investigate associations between transient rises and patient survival.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A retrospective review of patients in Auckland with a new diagnosis of colon cancer in 2001 or 2005 was performed and <jats:styled-content style="fixed-case">CEA</jats:styled-content> values were collected. Three patient groups were defined: no increase in <jats:styled-content style="fixed-case">CEA</jats:styled-content>; transient elevation in <jats:styled-content style="fixed-case">CEA</jats:styled-content>; and persistent elevation in <jats:styled-content style="fixed-case">CEA</jats:styled-content>. Kaplan–Meier methods were used to estimate 5‐year survival; Cox regression and log‐rank <jats:italic>P</jats:italic>‐values were used to compare survival.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Sixty‐one patients with stage <jats:styled-content style="fixed-case">II</jats:styled-content> or <jats:styled-content style="fixed-case">III</jats:styled-content> disease who had received adjuvant chemotherapy had sufficient <jats:styled-content style="fixed-case">CEA</jats:styled-content> data to be included in the analysis. Patients were followed up for a minimum of 7.4 years (or death). The 5‐year overall survival was higher in the transient elevation in <jats:styled-content style="fixed-case">CEA</jats:styled-content> group 95.0% and the no increase in <jats:styled-content style="fixed-case">CEA</jats:styled-content> group 85.2% compared with the persistent elevation in <jats:styled-content style="fixed-case">CEA</jats:styled-content> group 42.9%. There was no statistically significant difference in overall survival between the transient elevation group and the no increase group (<jats:italic>P</jats:italic> = 0.2).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The group with a transient elevation in <jats:styled-content style="fixed-case">CEA</jats:styled-content> during adjuvant chemotherapy did not have a poorer prognosis compared with the group that had no increase in <jats:styled-content style="fixed-case">CEA</jats:styled-content>. This will be further examined in a population‐based <jats:styled-content style="fixed-case">N</jats:styled-content>ew <jats:styled-content style="fixed-case">Z</jats:styled-content>ealand‐wide study of colorectal cancer diagnosis, treatment and outcome.</jats:p></jats:sec>
- Description: <jats:title>Abstract</jats:title><jats:sec><jats:title>Aims</jats:title><jats:p>Serum carcinoembryonic antigen (<jats:styled-content style="fixed-case">CEA</jats:styled-content>) is used to detect relapses from colon cancer following initial surgical or adjuvant treatment. There are little data on transient elevations of <jats:styled-content style="fixed-case">CEA</jats:styled-content> while receiving chemotherapy in the adjuvant setting. We aimed to review patterns of change in <jats:styled-content style="fixed-case">CEA</jats:styled-content> levels while receiving adjuvant chemotherapy and investigate associations between transient rises and patient survival.</jats:p></jats:sec><jats:sec><jats:title>Methods</jats:title><jats:p>A retrospective review of patients in Auckland with a new diagnosis of colon cancer in 2001 or 2005 was performed and <jats:styled-content style="fixed-case">CEA</jats:styled-content> values were collected. Three patient groups were defined: no increase in <jats:styled-content style="fixed-case">CEA</jats:styled-content>; transient elevation in <jats:styled-content style="fixed-case">CEA</jats:styled-content>; and persistent elevation in <jats:styled-content style="fixed-case">CEA</jats:styled-content>. Kaplan–Meier methods were used to estimate 5‐year survival; Cox regression and log‐rank <jats:italic>P</jats:italic>‐values were used to compare survival.</jats:p></jats:sec><jats:sec><jats:title>Results</jats:title><jats:p>Sixty‐one patients with stage <jats:styled-content style="fixed-case">II</jats:styled-content> or <jats:styled-content style="fixed-case">III</jats:styled-content> disease who had received adjuvant chemotherapy had sufficient <jats:styled-content style="fixed-case">CEA</jats:styled-content> data to be included in the analysis. Patients were followed up for a minimum of 7.4 years (or death). The 5‐year overall survival was higher in the transient elevation in <jats:styled-content style="fixed-case">CEA</jats:styled-content> group 95.0% and the no increase in <jats:styled-content style="fixed-case">CEA</jats:styled-content> group 85.2% compared with the persistent elevation in <jats:styled-content style="fixed-case">CEA</jats:styled-content> group 42.9%. There was no statistically significant difference in overall survival between the transient elevation group and the no increase group (<jats:italic>P</jats:italic> = 0.2).</jats:p></jats:sec><jats:sec><jats:title>Conclusions</jats:title><jats:p>The group with a transient elevation in <jats:styled-content style="fixed-case">CEA</jats:styled-content> during adjuvant chemotherapy did not have a poorer prognosis compared with the group that had no increase in <jats:styled-content style="fixed-case">CEA</jats:styled-content>. This will be further examined in a population‐based <jats:styled-content style="fixed-case">N</jats:styled-content>ew <jats:styled-content style="fixed-case">Z</jats:styled-content>ealand‐wide study of colorectal cancer diagnosis, treatment and outcome.</jats:p></jats:sec>
- Footnote: