184P - Carcinoembryonic antigen is a definite predictor of tumor downstaging and recurrence in rectal cancer after preoperative chemoradiotherapy and cura...

Date 19 December 2015
Event ESMO Asia 2015 Congress
Session Poster presentation 1
Topics Anticancer Agents
Surgical Oncology
Colon and Rectal Cancer
Biological Therapy
Radiation Oncology
Presenter Jong Hoon Lee
Citation Annals of Oncology (2015) 26 (suppl_9): 42-70. 10.1093/annonc/mdv523
Authors J.H. Lee
  • Department Of Radiation Oncology, St Vincent Hospital The Catholic University of Korea, 1234 - Suwon/KR



Korean Radiation Oncology Group evaluated the significance of carcinoembryonic antigen (CEA) levels both as a predictor of tumor response after CRT and as a prognosticator for recurrence-free survival.


1804 rectal cancer patients, staged cT3-4N0-2M0, participated in a multicenter study. The patients were administered preoperative radiation of 50.4 Gy in 28 fractions with 5-FU or capecitabine, followed by total mesorectal excision. Patients with elevated CEA levels (>5 ng/mL) were matched at a 1 (n = 595): 1 (n = 595) ratio with patients with normal CEA (≤5 ng/mL). The tumor response after CRT and the recurrence-free survival (RFS) rates were evaluated and compared between two arms.


An elevated CEA level (p < 0.001) was determined to be a significant negative predictor of downstaging after CRT. The downstaging rate was 42.9% for normal CEA and 23.4% for elevated CEA. A multivariate analysis also revealed that cT (p = 0.021) and cN classification (p = 0.001), tumor size (p = 0.002), and tumor location from the anal verge (p = 0.006) were significant predictors for tumor downstaging. The 5-year RFS rates were significantly higher for the normal CEA arm than for the elevated CEA arm (74.2 vs. 63.5 %, p < 0.001).


Elevated CEA (>5 ng/mL) is a negative predictor of tumor downstaging after CRT and also has a negative impact on RFS in rectal cancer.

Clinical trial identification


All authors have declared no conflicts of interest.