Preoperative carcinoembryonic antigen predicts outcomes in node-negative colon cancer patients

A multivariate analysis of 572 patients

Lawrence Harrison, Jose G. Guillem, Philip Paty, Alfred M. Cohen

Research output: Contribution to journalArticle

148 Citations (Scopus)

Abstract

Background: Although prospective trials have demonstrated that postoperative chemotherapy for node-positive colon cancer patients provides survival benefit, no improvement in survival has been documented for node- negative colon cancer patients. There are, however, a subset of node-negative patients that go on to die of their disease. We hypothesize that this subset of node-negative patients may benefit from postoperative chemotherapy. We analyzed a large cohort of node-negative colon cancer patients from a single institution to determine prognostic factors that predict which patients with node-negative colon cancer might experience recurrence and can benefit from postoperative chemotherapy. Study Design: A review of the prospective database for colorectal cancer at Memorial Sloan-Kettering Cancer Center (MSKCC) between 1985 and 1993 identified 572 patients who underwent curative resection for node-negative colon cancer (T1,2,34N0M0). Demographic, serum, and pathologic factors were analyzed for prognostic significance. Survival was calculated by the method of Kaplan-Meier and compared by log rank test. Multivariate analysis was calculated by the Cox proportional hazard model. Results: Median follow-up was 35 months. Factors predictive of survival by univariate analysis include tumor stage, overall stage, and preoperative serum carcinoembryonic antigen (CEA) elevation. By multivariate analysis, overall stage and preoperative serum CEA level predicted survival. Conclusions: Routine histologic and demographic factors do not predict outcome in node-negative colon cancer patients. Preoperative CEA and overall stage predict survival by multivariate analysis. Preoperative CEA elevation in node-negative patients identifies a group of patients that has a poor prognosis and defines a subset of patients who may benefit from postoperative chemotherapy.

Original languageEnglish (US)
Pages (from-to)55-59
Number of pages5
JournalJournal of the American College of Surgeons
Volume185
Issue number1
DOIs
StatePublished - Jan 1 1997
Externally publishedYes

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Carcinoembryonic Antigen
Colonic Neoplasms
Multivariate Analysis
Drug Therapy
Survival
Survival Analysis
Serum
Demography
Proportional Hazards Models
Colorectal Neoplasms
Neoplasms
Databases
Recurrence

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

@article{a833ae6e48c74e249a272e9a7a43f0cd,
title = "Preoperative carcinoembryonic antigen predicts outcomes in node-negative colon cancer patients: A multivariate analysis of 572 patients",
abstract = "Background: Although prospective trials have demonstrated that postoperative chemotherapy for node-positive colon cancer patients provides survival benefit, no improvement in survival has been documented for node- negative colon cancer patients. There are, however, a subset of node-negative patients that go on to die of their disease. We hypothesize that this subset of node-negative patients may benefit from postoperative chemotherapy. We analyzed a large cohort of node-negative colon cancer patients from a single institution to determine prognostic factors that predict which patients with node-negative colon cancer might experience recurrence and can benefit from postoperative chemotherapy. Study Design: A review of the prospective database for colorectal cancer at Memorial Sloan-Kettering Cancer Center (MSKCC) between 1985 and 1993 identified 572 patients who underwent curative resection for node-negative colon cancer (T1,2,34N0M0). Demographic, serum, and pathologic factors were analyzed for prognostic significance. Survival was calculated by the method of Kaplan-Meier and compared by log rank test. Multivariate analysis was calculated by the Cox proportional hazard model. Results: Median follow-up was 35 months. Factors predictive of survival by univariate analysis include tumor stage, overall stage, and preoperative serum carcinoembryonic antigen (CEA) elevation. By multivariate analysis, overall stage and preoperative serum CEA level predicted survival. Conclusions: Routine histologic and demographic factors do not predict outcome in node-negative colon cancer patients. Preoperative CEA and overall stage predict survival by multivariate analysis. Preoperative CEA elevation in node-negative patients identifies a group of patients that has a poor prognosis and defines a subset of patients who may benefit from postoperative chemotherapy.",
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Preoperative carcinoembryonic antigen predicts outcomes in node-negative colon cancer patients : A multivariate analysis of 572 patients. / Harrison, Lawrence; Guillem, Jose G.; Paty, Philip; Cohen, Alfred M.

In: Journal of the American College of Surgeons, Vol. 185, No. 1, 01.01.1997, p. 55-59.

Research output: Contribution to journalArticle

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