Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients with chronic kidney disease

Chih-Sheng Huang; Li-Kuo Huang; Chin-Yau Chen; Wei-Shu Wang; Shung-Haur Yang

doi:10.1016/j.amjsurg.2020.07.015

Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients with chronic kidney disease

Am J Surg. 2021 Jan;221(1):162-167. doi: 10.1016/j.amjsurg.2020.07.015. Epub 2020 Jul 25.

Authors

Chih-Sheng Huang¹, Li-Kuo Huang², Chin-Yau Chen³, Wei-Shu Wang⁴, Shung-Haur Yang⁵

Affiliations

¹ Department of Surgery, National Yang-Ming University Hospital, No.169, Siaoshe Rd., Yilan City, Yilan County 26058, Taiwan; School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 11221 Taiwan. Electronic address: imalive20@hotmail.com.
² School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 11221 Taiwan; Department of Radiology, National Yang-Ming University Hospital, No.169, Siaoshe Rd., Yilan City, Yilan County, 26058, Taiwan.
³ Department of Surgery, National Yang-Ming University Hospital, No.169, Siaoshe Rd., Yilan City, Yilan County 26058, Taiwan; School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 11221 Taiwan.
⁴ School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 11221 Taiwan; Division of Oncology, Department of Internal Medicine, National Yang-Ming University Hospital, No.169, Siaoshe Rd., Yilan City, Yilan County, 26058, Taiwan.
⁵ Department of Surgery, National Yang-Ming University Hospital, No.169, Siaoshe Rd., Yilan City, Yilan County 26058, Taiwan; School of Medicine, National Yang-Ming University, No.155, Sec.2, Linong Street, Taipei, 11221 Taiwan; Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, No.201, Sec. 2, Shipai Rd., Beitou District, Taipei, 11217 Taiwan.

PMID: 32746979
DOI: 10.1016/j.amjsurg.2020.07.015

Abstract

Background: Chronic kidney disease (CKD) can increase serum carcinoembryonic antigen (CEA) levels. We thus aimed to evaluate the impact of CKD on CEA prognostic accuracy in colorectal cancer.

Methods: Altogether, 429 patients who underwent curative resection for stages I-III colorectal adenocarcinoma were grouped according to postoperative CEA levels and history of CKD.

Results: Three-year disease-free survival (DFS) was higher in patients with normal postoperative CEA (group A, 83.4%) than in those with elevated postoperative CEA (group B, 64.3%) (p < 0.001). CKD patients had higher postoperative CEA levels than non-CKD patients (odds ratio 3.27, 95% confidence interval 1.78-5.99, p < 0.001). In multivariable analysis, postoperative CEA level was an independent prognostic factor for DFS in non-CKD, but not CKD, patients.

Conclusions: CKD can increase postoperative CEA levels in colorectal cancer patients. Elevated postoperative CEA levels were associated with shorter DFS in non-CKD, but not CKD, patients.

Keywords: Carcinoembryonic antigen; Chronic kidney disease; Colorectal cancer.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Adenocarcinoma / blood*
Adenocarcinoma / complications
Adenocarcinoma / mortality*
Adenocarcinoma / surgery
Adult
Aged
Aged, 80 and over
Carcinoembryonic Antigen / blood*
Colorectal Neoplasms / blood*
Colorectal Neoplasms / complications
Colorectal Neoplasms / mortality*
Colorectal Neoplasms / surgery
Disease-Free Survival
Female
Humans
Male
Middle Aged
Postoperative Period
Prognosis
Renal Insufficiency, Chronic / blood*
Renal Insufficiency, Chronic / complications*
Retrospective Studies

Substances

Carcinoembryonic Antigen