Independent Prognostic Role of Postoperative Carcinoembryonic Antigen in Stage II Colon Cancer

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Birsin Z., Aliyev V., Jeral N. S., Cebeci S., Abbasov H., Demirci N. S., ...Daha Fazla

Cerrahpaşa Medical Journal, cilt.2025, sa.49, ss.1-8, 2025 (TRDizin)

Özet

Objective: Preoperative carcinoembryonic antigen (CEA) is often considered when making adjuvant ther-apy decisions for stage II colon cancer, whereas postoperative CEA is not routinely used. The aim was to evaluate its prognostic significance.Methods: A total of 179 patients with stage II colon cancer who underwent curative resection between 2010 and 2024 were retrospectively analyzed. Postoperative CEA (post-CEA) was measured within 1 month after surgery. An elevated CEA was defined as 5.0 ng/mL, based on a cutoff confirmed by receiver operating characteristic analysis. Survival outcomes were analyzed using Kaplan–Meier and Cox regression models.Results: Postoperative CEA was ≥5 ng/mL in 18 (10%) of patients. Elevated postoperative CEA was strongly associated with recurrence (67% vs. 7%, P< .001) and mortality (50% vs. 10%, P< .001). Five-year relapse-free survival was 90% in patients with CEA <5 ng/mL compared with 42% in those with CEA ≥5 ng/mL (P< .001). Five-year overall survival was 94% versus 63% (P = .001). In multivariate analysis, postoperative CEA ≥5 ng/mL and T4 stage remained independent adverse prognostic factors.Conclusion: Elevated postoperative CEA is an independent prognostic biomarker in stage II colon cancer. Its low cost and availability support its consideration as a high-risk factor for adjuvant decision-making, though prospective validation is required to confirm its role and optimal cutoff: Preoperative carcinoembryonic antigen (CEA) is often considered when making adjuvant ther-apy decisions for stage II colon cancer, whereas postoperative CEA is not routinely used. The aim was to evaluate its prognostic significance.Methods: A total of 179 patients with stage II colon cancer who underwent curative resection between 2010 and 2024 were retrospectively anüalyzed. Postoperative CEA (post-CEA) was measured within 1 month after surgery. An elevated CEA was defined as 5.0 ng/mL, based on a cutoff confirmed by receiver operating characteristic analysis. Survival outcomes were analyzed using Kaplan–Meier and Cox regression models.Results: Postoperative CEA was ≥5 ng/mL in 18 (10%) of patients. Elevated postoperative CEA was strongly associated with recurrence (67% vs. 7%, P< .001) and mortality (50% vs. 10%, P< .001). Five-year relapse-free survival was 90% in patients with CEA <5 ng/mL compared with 42% in those with CEA ≥5 ng/mL (P< .001). Five-year overall survival was 94% versus 63% (P = .001). In multivariate analysis, postoperative CEA ≥5 ng/mL and T4 stage remained independent adverse prognostic factors.Conclusion: Elevated postoperative CEA is an independent prognostic biomarker in stage II colon cancer. Its low cost and availability support its consideration as a high-risk factor for adjuvant decision-making, though prospective validation is required to confirm its role and optimal cutoff