Revista chilena de cirugía
versión On-line ISSN 0718-4026
BANNURA C, GUILLERMO et al. Preoperative carcinoembriogenic antigen as prognostic factor in colorectal carcinoma. Rev Chil Cir [online]. 2008, vol.60, n.4, pp. 320-325. ISSN 0718-4026. doi: 10.4067/S0718-40262008000400010.
Background: The real usefulness of preoperative carcinoembrionic antigen (CEA) as prognostic factor ¡n colorectal cáncer is not clearly defined. Aim: To assess the prognostic valué of CEA in colorectal cáncer. Materialandmethods: Followup, during 2 to 186 months, of 532 patients aged 21 to 92years (54%females) operated for a colorectal cáncer and in whom a preoperative determination of CEA was available. Tumor staging was done using the American Joint Committee on Cáncer classification. Survival was determined using Ufe tables. A Cox regression model was used to determine relevant prognosticfactors. Results: Mean preoperative CEA was 21.4 ± 70.7 ng/ml and was over 5 ng/ml in 38% of patients. There was a strong association between CEA and tumor stage. Multivariate analysis disclosed location (rectum), lymph node involvement and preoperative CEA as independent prognostic factors. If TNM tumor stage is introduced in the Cox model, a significant difference in survival among patients with abnormal CEA valúes, is observed for rectal tumors with a Odds ratio of 2.02 and 95% confidence intervals (Cl) of 1.35-3.03, for stage III tumors, with an odds ratio of 4.19 (95% Cl 10.8-16.24) and for stage IV tumors, with an odds ratio of 30.36 (95% Cl 8.39-109.8). Conclusions: Preoperative CEA and the extensión of colorectal tumors are independent prognostic factors for survival. The strong association between tumor stage and CEA valúes, determines that the latter outweigh the former as prognostic factor
Palabras clave : Colorectal carcinoma; carcinoembrionic antigen; survival.