Prognostic Impact of Pretreatment Elevated and Normalized Carcinoembryonic Antigen Levels After Neoadjuvant Chemoradiotherapy in Resected Locally Advanced Rectal Cancer Patients

PURPOSE: The prognostic significance of pretreatment elevated and normalized CEA after neoadjuvant chemoradiotherapy (nCRT) was evaluated. MATERIALS AND METHODS: The characteristics of 951 locally advanced rectal cancer patients with nCRT were retrieved and were analyzed retrospectively. Pretreatment CEA levels were defined as CEA evaluated one week prior to the nCRT. CEA after nCRT was deemed as CEA measured one week before surgery. The normal CEA levels were set at <5 ng/mL. The normal CEA group was defined as patients with normal pretreatment CEA levels. The normalized CEA group was defined as patients with elevated pretreatment CEA levels and normal CEA levels after nCRT. The elevated CEA group was defined as patients with elevated pretreatment CEA levels and elevated CEA levels after nCRT. RESULTS: Compared with the elevated CEA group, the normalized CEA group was associated with better overall survival (OS) (HR: 0.625, 95%CI: 0.416–0.938, P=0.022). There was no difference between the normalized CEA group and the normal CEA group (HR: 1.143, 95%CI: 0.84–1.557, P=0.395). CONCLUSION: In conclusion, the study indicated that OS of the normalized CEA group and the normal CEA group was better than the elevated CEA group.