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Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke.
PLoS One. 2020; 15(6):e0233687.Plos

Abstract

Serum carcinoembryonic antigen (CEA) levels can help predict the prognosis of colorectal cancer patients. Accordingly, high preoperative CEA levels that is not restored after surgery are indicative of a worse outcome. On the other hand, smoking can increase serum CEA levels independently of the disease status. Thus, we aimed to evaluate the impact of smoking on the prognostic value of serum CEA levels. This retrospective cohort study included 273 patients who underwent curative resection for stage I-III colorectal adenocarcinoma at a single institution, between January 2010 and December 2017. Patients were grouped as follows: group A, normal preoperative and postoperative CEA levels (n = 152); group B, elevated preoperative CEA levels that returned to reference values after surgery (n = 69); and group C, elevated postoperative serum CEA levels (n = 52). Patients were also grouped according to their smoking history: group S (current smokers, n = 79) and group NS (never and former smokers, n = 194). Group A showed a higher 3-year disease-free survival (DFS) rate (84.9%) than groups B (75.4%) and C (62.0%) (p < 0.001). Postoperative serum CEA levels were significantly higher in the S group than in the NS group (2.6 vs. 3.1 ng/mL, p = 0.009), whereas preoperative levels were similar (3.8 vs. 4.1, p = 0.182). Further, smokers showed higher 3 year-DFS rates than nonsmokers in group C (83.3% vs. 43.9%, p = 0.029). This suggests that while elevated postoperative CEA levels are associated with lower DFS rates in never and former smokers, they are not associated with lower DFS rates in current smokers. We conclude that persistent smoking alters the prognostic value of postoperative serum CEA levels in colorectal cancer patients and that, consequently, alternative surveillance strategies need to be developed for colon cancer patients with smoking habits.

Authors+Show Affiliations

Department of Surgery, National Yang-Ming University Hospital, Yilan, Taiwan. School of Medicine, National Yang-Ming University, Taipei, Taiwan.Department of Surgery, National Yang-Ming University Hospital, Yilan, Taiwan. School of Medicine, National Yang-Ming University, Taipei, Taiwan.School of Medicine, National Yang-Ming University, Taipei, Taiwan. Department of Radiology, National Yang-Ming University Hospital, Yilan, Taiwan.School of Medicine, National Yang-Ming University, Taipei, Taiwan. Division of Oncology, Department of Internal Medicine, National Yang-Ming University Hospital, Yilan, Taiwan.Department of Surgery, National Yang-Ming University Hospital, Yilan, Taiwan. School of Medicine, National Yang-Ming University, Taipei, Taiwan. Division of Colon and Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.

Pub Type(s)

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

Language

eng

PubMed ID

32502149

Citation

Huang, Chih-Sheng, et al. "Prognostic Value of Postoperative Serum Carcinoembryonic Antigen Levels in Colorectal Cancer Patients Who Smoke." PloS One, vol. 15, no. 6, 2020, pp. e0233687.
Huang CS, Chen CY, Huang LK, et al. Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke. PLoS ONE. 2020;15(6):e0233687.
Huang, C. S., Chen, C. Y., Huang, L. K., Wang, W. S., & Yang, S. H. (2020). Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke. PloS One, 15(6), e0233687. https://doi.org/10.1371/journal.pone.0233687
Huang CS, et al. Prognostic Value of Postoperative Serum Carcinoembryonic Antigen Levels in Colorectal Cancer Patients Who Smoke. PLoS ONE. 2020;15(6):e0233687. PubMed PMID: 32502149.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke. AU - Huang,Chih-Sheng, AU - Chen,Chin-Yau, AU - Huang,Li-Kuo, AU - Wang,Wei-Shu, AU - Yang,Shung-Haur, Y1 - 2020/06/05/ PY - 2020/02/13/received PY - 2020/05/10/accepted PY - 2020/6/6/entrez PY - 2020/6/6/pubmed PY - 2020/8/18/medline SP - e0233687 EP - e0233687 JF - PloS one JO - PLoS ONE VL - 15 IS - 6 N2 - Serum carcinoembryonic antigen (CEA) levels can help predict the prognosis of colorectal cancer patients. Accordingly, high preoperative CEA levels that is not restored after surgery are indicative of a worse outcome. On the other hand, smoking can increase serum CEA levels independently of the disease status. Thus, we aimed to evaluate the impact of smoking on the prognostic value of serum CEA levels. This retrospective cohort study included 273 patients who underwent curative resection for stage I-III colorectal adenocarcinoma at a single institution, between January 2010 and December 2017. Patients were grouped as follows: group A, normal preoperative and postoperative CEA levels (n = 152); group B, elevated preoperative CEA levels that returned to reference values after surgery (n = 69); and group C, elevated postoperative serum CEA levels (n = 52). Patients were also grouped according to their smoking history: group S (current smokers, n = 79) and group NS (never and former smokers, n = 194). Group A showed a higher 3-year disease-free survival (DFS) rate (84.9%) than groups B (75.4%) and C (62.0%) (p < 0.001). Postoperative serum CEA levels were significantly higher in the S group than in the NS group (2.6 vs. 3.1 ng/mL, p = 0.009), whereas preoperative levels were similar (3.8 vs. 4.1, p = 0.182). Further, smokers showed higher 3 year-DFS rates than nonsmokers in group C (83.3% vs. 43.9%, p = 0.029). This suggests that while elevated postoperative CEA levels are associated with lower DFS rates in never and former smokers, they are not associated with lower DFS rates in current smokers. We conclude that persistent smoking alters the prognostic value of postoperative serum CEA levels in colorectal cancer patients and that, consequently, alternative surveillance strategies need to be developed for colon cancer patients with smoking habits. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/32502149/Prognostic_value_of_postoperative_serum_carcinoembryonic_antigen_levels_in_colorectal_cancer_patients_who_smoke_ L2 - https://dx.plos.org/10.1371/journal.pone.0233687 DB - PRIME DP - Unbound Medicine ER -