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document
Prognostic value of postoperative CEA clearance in rectal cancer patients with high preoperative CEA levels . PURPOSE We determined the prognostic value of carcinoembryonic antigen ( CEA ) clearance after tumor resection with serial evaluation of postoperative CEA levels in rectal cancer . METHODS Between 1994 and 2004 , we retrospectively reviewed 122 patients with rectal cancer whose serum CEA levels were measured on the preoperative day and postoperative days 7 and 30 . Patients with preoperative CEA levels < 5.0 ng/ml were excluded . An exponential trend line was drawn using the three CEA values . Patients were categorized into three groups based on R ( 2 ) values calculated through trend line , which indicates the correlation coefficient between exponential graph and measured CEA values : exponential decrease group ( group 1 : 0.9 < R ( 2 ) < or = 1.0 ) , nearly exponential decrease group ( group 2 : 0.5 < R ( 2 ) < or = 0.9 ) , and randomized clearance group ( group 3 : 0.5 < or = R ( 2 ) ) . We then analyzed the CEA clearance pattern as a prognostic indicator . RESULTS With a median follow-up of 57 months , the 5-year overall survival was 62.3 % vs. 48.1 % vs. 25 % and the 5-year disease-free survival was 58.6 % vs. 52.7 % vs. 25 % among groups 1 , 2 , and 3 ( P = 0.014 , P = 0.027 , respectively ) in patients with stage III rectal cancer . For those with stage II rectal cancer , the 5-year overall survival rate of group 1 was significantly better than groups 2 and 3 ( 88.8 % vs. 74.1 % , respectively , P = 0.021 ) . CONCLUSIONS The postoperative pattern of CEA clearance is a useful prognostic determinant in patients with rectal cancer . Patients with a randomized pattern of CEA clearance after tumor resection should be regarded as having the possibility of a persistent CEA source and may require consideration of intensive follow-up or adjuvant therapy .
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Intervention_Surgical
postoperative CEA clearance
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Intervention_Surgical
tumor resection
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Intervention_Surgical
postoperative pattern of CEA clearance
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Outcome_Physical
serum CEA levels
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Outcome_Physical
CEA values
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Outcome_Mortality
5-year overall survival
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Outcome_Mortality
5-year disease-free survival
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Outcome_Mortality
5-year overall survival rate
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Outcome_Physical
CEA clearance
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Participant_Condition
rectal cancer patients with high preoperative CEA levels .
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Participant_Sample-size
122