Implications of Pretreatment Serum Carcinoembryonic Antigen Levels and Perineural Invasion with Staging, Prognosis, and Management in Stage I-III Colon Cancer after Surgery: A Retrospective Cohort Study in the SEER Database

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Published: Apr 20, 2024
DOI: https://doi.org/10.62713/aic.3296
Keywords:
CEA, perineural invasion, TNM staging system, colon cancer, prognosis, SEER

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Qing Zhang
Department of Breast Surgery, Breast Cancer Center, The Affiliated Taian City Central Hospital of Qingdao University, 271000 Taian, Shandong, China
Li Wang
Department of Breast Surgery, Breast Cancer Center, The Affiliated Taian City Central Hospital of Qingdao University, 271000 Taian, Shandong, China
Ruirui Sun
Department of Breast Surgery, Breast Cancer Center, The Affiliated Taian City Central Hospital of Qingdao University, 271000 Taian, Shandong, China
Jian Gao
Department of Breast Surgery, Breast Cancer Center, The Affiliated Taian City Central Hospital of Qingdao University, 271000 Taian, Shandong, China
Tingting Liu
Department of Breast Surgery, Breast Cancer Center, The Affiliated Taian City Central Hospital of Qingdao University, 271000 Taian, Shandong, China

Abstract

Background: Pretreatment levels of serum carcinoembryonic antigen (CEA) and perineural invasion (PNI) are related to poor prognosis in colon cancer. We analyzed the CEA and PNI (defined as incorporation of carcinoembryonic antigen and perineural invasion (CP)-stage), which are included in the Tumor-Node-Metastasis (TNM) staging system of the American Joint Committee on Cancer (AJCC), and evaluated the survival prognosis of patients treated with surgery in I-III stage colon carcinoma. 


Materials and Methods: We employed a retrospective study for eligible colon carcinoma patients obtained from the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015. Kaplan-Meier curve and Multivariate Cox regression analysis were used to analyze different TNM-CP stages for the cancer-specific survival (CSS) probabilities in colon cancer. 


Result: In our study, CEA levels and PNI were significant prognostic factors (p < 0.05), and the newly proposed CP-stage was an independent prognostic index in stage I-III colon carcinoma after surgery. Multivariate Cox regression analyses indicated that CP1-stage was related to a 63.9% increased risk of cancer-specific mortality (hazard ratio (HR): 1.639, 95% confidence interval (CI): 1.544–1.739, p < 0.001), compared with CP0-stage in colon cancer. In respective TNM stages, the CP0-stage had an advantage over the CP1-stage for CSS (p < 0.001). Moreover, CP1-stage patients with node-negative colon cancer were contacted with similar or worse survival in comparison to CP0-stage patients with node-positive. 


Conclusion: For postoperative patients with stage I-III colon cancer, our study indicated that the CP stage is a significant prognostic factor for CSS, which deserves more clinical attention. It's worth noting that including the CP stage in the AJCC TNM staging system of colon carcinoma is beneficial to the survival prediction and clinical treatment.

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How to Cite
Zhang, Qing, et al. “Implications of Pretreatment Serum Carcinoembryonic Antigen Levels and Perineural Invasion With Staging, Prognosis, and Management in Stage I-III Colon Cancer After Surgery: A Retrospective Cohort Study in the SEER Database”. Annali Italiani Di Chirurgia, vol. 95, no. 2, Apr. 2024, pp. 144-5, doi:10.62713/aic.3296.
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Vol. 95 No. 2 (2024)
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