183P - Importance of carcinoembryonic antigen on disease control and survival in elderly rectal cancer patients with comorbid condition

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Biomarkers
Geriatric Oncology
Rectal Cancer
Presenter Taeryool Koo
Citation Annals of Oncology (2016) 27 (suppl_9): ix53-ix67. 10.1093/annonc/mdw581
Authors T. Koo1, H. Bae2, M. Lee2, H.C. Park3, S.W. Lim3
  • 1Radiation Oncology, Chuncheon Sacred Heart Hospital, Hallym University, 200-704 - Chuncheon/KR
  • 2Radiation Oncology, Hallym University Medical Center Hallym University College of Medicine, 431-796 - Anyang/KR
  • 3Surgery, Hallym University Medical Center Hallym University College of Medicine, 431-796 - Anyang/KR

Abstract

Background

Neoadjuvant chemoradiotherapy and total mesorectal excision (TME) is the standard treatment for rectal cancer. In elderly patients with rectal cancer, however, varied treatment methods are used considering age and underlying diseases. We aimed to analyze treatment outcomes and evaluate prognostic factors in rectal cancer patients aged of 65 years and older, who received TME alone or combined modality treatment.

Methods

Medical records of 273 patients with stage II-III rectal cancer who underwent TME in Hallym Sacred Heart Hospital from 2006 and 2014 were retrospectively reviewed. Of these, 93 patients with 65 years and older age were included in this study. Neoadjuvant or adjuvant chemoradiotherapy was given in 38 patients, adjuvant chemotherapy was administered in 32 patients, and TME alone was performed in 23 patients. The age-adjusted Charlson comorbidity index (ACCI) was used to quantify comorbid condition of patients.

Results

Median follow-up time was 48.9 months in surviving patients. Five-year overall survival (OS), progression-free survival (PFS), and locoregional PFS (LPFS) were 66.1%, 69.2%, and 81.4%, respectively. In multivariate analyses, elevated initial carcinoembryonic antigen (CEA) level (>5 ng/ml) was an independent prognostic factor of OS (hazard ratio [HR] 2.716, p = 0.007) and PFS (HR 3.582, p = 0.001). High ACCI (≥4) was associated with OS (HR 2.469, p = 0.050) alone. cT stage (cT4) have an association with LPFS (HR 4.819, p = 0.041). When the patients with low ACCI were divided into two groups according to initial CEA level, the high CEA group had poorer survival than the low CEA group (HR 5.766, p = 0.046).

Conclusions

In this study, the initial CEA level was a useful prognostic factor encompassing disease progression as well as survival in elderly rectal cancer patients with curative resection. The patients might receive insufficient treatment when comorbidities were considered alone. The decision of treatment modality could be more optimized with the use of initial CEA level in elderly rectal cancer patients.

Clinical trial indentification

Legal entity responsible for the study

N/A

Funding

N/A

Disclosure

All authors have declared no conflicts of interest.