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Article: Transient carcinoembryonic antigen elevations during adjuvant chemotherapy for colorectal cancer reflect the burden of residual micrometastatic disease

TitleTransient carcinoembryonic antigen elevations during adjuvant chemotherapy for colorectal cancer reflect the burden of residual micrometastatic disease
Authors
KeywordsBiomarkers
Chromosome 19q
Predictive factors
Tumor markers
Issue Date2010
PublisherCancer Information Group, LP. The Journal's web site is located at http://cigjournals.metapress.com/content/121020/
Citation
Clinical Colorectal Cancer, 2010, v. 9 n. 2, p. 108-112 How to Cite?
AbstractBackground: Carcinoembryonic antigen (CEA) testing is routinely used to monitor the progress of patients with advanced cancer on treatment, or else to detect relapse during follow-up, particularly in colorectal cancer (CRC). Although CEA levels have been reported to rise during adjuvant drug therapies, the mechanism of such 'surges' is not clear. This study was conducted to clarify the clinical significance of this phenomenon. Patients and Methods: We conducted a retrospective analysis of CEA levels in 88 consecutive patients receiving adjuvant chemotherapy in our center: 39 patients with primary CRC and a comparison cohort of 49 patients with breast cancer treated with adjuvant chemotherapy. In the event of 2 serial CEA increases, endoscopic and/or imaging investigations were performed to exclude recurrence. Subset analyses were based on nodal status and primary tumor type. Results: Primary resection was associated with significant CEA decline in patients with CRC but not in those with breast cancer. Forty-three patients (48.9%) experienced CEA fluctuations exceeding 0.5 ng/mL during adjuvant chemotherapy; CEA increases indicated true recurrence in 2 patients (4.7%). Adjuvant CEA surges occurred both more often and more extensively in disease associated with ≥ 4 positive nodes in patients with CRC but not in patients with breast cancer (P < .05). Conclusion: Both the frequency and extent of CEA surges during adjuvant chemotherapy parallel the severity of preoperative nodal involvement in CRC but not in breast cancer, suggesting that such surges reflect tumorilytic effects on occult disease in patients with CRC only. However, whether these CEA surges predict survival that is inferior (ie, because of greater burden of residual disease) or superior (ie, because of greater tumorilytic efficacy) to that of stagematched 'nonsurge' patients, remains to be determined by larger, prospective CRC studies.
Persistent Identifierhttp://hdl.handle.net/10722/135517
ISSN
2023 Impact Factor: 3.3
2023 SCImago Journal Rankings: 1.336
ISI Accession Number ID
Funding AgencyGrant Number
Lineberger Comprehensive Cancer Center
NIH1KL2RR025746-01
Funding Information:

This project was funded by a Lineberger Comprehensive Cancer Center Developmental Award and NIH 1KL2RR025746-01.

References

 

DC FieldValueLanguage
dc.contributor.authorYau, Ten_HK
dc.contributor.authorWong, Hen_HK
dc.contributor.authorChan, Pen_HK
dc.contributor.authorChan, Ten_HK
dc.contributor.authorMak, Jen_HK
dc.contributor.authorEpstein, Ren_HK
dc.date.accessioned2011-07-27T01:36:22Z-
dc.date.available2011-07-27T01:36:22Z-
dc.date.issued2010en_HK
dc.identifier.citationClinical Colorectal Cancer, 2010, v. 9 n. 2, p. 108-112en_HK
dc.identifier.issn1533-0028en_HK
dc.identifier.urihttp://hdl.handle.net/10722/135517-
dc.description.abstractBackground: Carcinoembryonic antigen (CEA) testing is routinely used to monitor the progress of patients with advanced cancer on treatment, or else to detect relapse during follow-up, particularly in colorectal cancer (CRC). Although CEA levels have been reported to rise during adjuvant drug therapies, the mechanism of such 'surges' is not clear. This study was conducted to clarify the clinical significance of this phenomenon. Patients and Methods: We conducted a retrospective analysis of CEA levels in 88 consecutive patients receiving adjuvant chemotherapy in our center: 39 patients with primary CRC and a comparison cohort of 49 patients with breast cancer treated with adjuvant chemotherapy. In the event of 2 serial CEA increases, endoscopic and/or imaging investigations were performed to exclude recurrence. Subset analyses were based on nodal status and primary tumor type. Results: Primary resection was associated with significant CEA decline in patients with CRC but not in those with breast cancer. Forty-three patients (48.9%) experienced CEA fluctuations exceeding 0.5 ng/mL during adjuvant chemotherapy; CEA increases indicated true recurrence in 2 patients (4.7%). Adjuvant CEA surges occurred both more often and more extensively in disease associated with ≥ 4 positive nodes in patients with CRC but not in patients with breast cancer (P < .05). Conclusion: Both the frequency and extent of CEA surges during adjuvant chemotherapy parallel the severity of preoperative nodal involvement in CRC but not in breast cancer, suggesting that such surges reflect tumorilytic effects on occult disease in patients with CRC only. However, whether these CEA surges predict survival that is inferior (ie, because of greater burden of residual disease) or superior (ie, because of greater tumorilytic efficacy) to that of stagematched 'nonsurge' patients, remains to be determined by larger, prospective CRC studies.en_HK
dc.languageengen_US
dc.publisherCancer Information Group, LP. The Journal's web site is located at http://cigjournals.metapress.com/content/121020/ en_HK
dc.relation.ispartofClinical Colorectal Canceren_HK
dc.subjectBiomarkersen_HK
dc.subjectChromosome 19qen_HK
dc.subjectPredictive factorsen_HK
dc.subjectTumor markersen_HK
dc.subject.meshAntineoplastic Agents - therapeutic use-
dc.subject.meshBreast Neoplasms - drug therapy - pathology - surgery-
dc.subject.meshCarcinoembryonic Antigen - blood-
dc.subject.meshColorectal Neoplasms - drug therapy - pathology - surgery-
dc.subject.meshChemotherapy, Adjuvant-
dc.titleTransient carcinoembryonic antigen elevations during adjuvant chemotherapy for colorectal cancer reflect the burden of residual micrometastatic diseaseen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1533-0028&volume=9&issue=2&spage=108&epage=112&date=2010&atitle=Transient+carcinoembryonic+antigen+elevations+during+adjuvant+chemotherapy+for+colorectal+cancer+reflect+the+burden+of+residual+micrometastatic+diseaseen_US
dc.identifier.emailYau, T: tyaucc@hku.hken_HK
dc.identifier.emailEpstein, R: repstein@hku.hken_HK
dc.identifier.authorityYau, T=rp01466en_HK
dc.identifier.authorityEpstein, R=rp00501en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.3816/CCC.2010.n.015en_HK
dc.identifier.pmid20378505-
dc.identifier.scopuseid_2-s2.0-77950791067en_HK
dc.identifier.hkuros185926en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-77950791067&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume9en_HK
dc.identifier.issue2en_HK
dc.identifier.spage108en_HK
dc.identifier.epage112en_HK
dc.identifier.isiWOS:000276633800006-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYau, T=23391533100en_HK
dc.identifier.scopusauthoridWong, H=23089414000en_HK
dc.identifier.scopusauthoridChan, P=7403497715en_HK
dc.identifier.scopusauthoridChan, T=7402687666en_HK
dc.identifier.scopusauthoridMak, J=7103323435en_HK
dc.identifier.scopusauthoridEpstein, R=34975074500en_HK
dc.identifier.issnl1533-0028-

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