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Carcinoembryonic Antigen Improves the Performance of Magnetic Resonance Imaging in the Prediction of Pathologic Response after Neoadjuvant Chemoradiation for Patients with Rectal Cancer
- Source :
- Cancer Research and Treatment : Official Journal of Korean Cancer Association
- Publication Year :
- 2020
- Publisher :
- Korean Cancer Association, 2020.
-
Abstract
- PurposeThe purpose of this study was to investigate the role of carcinoembryonic antigen (CEA) levels in improving the performance of magnetic resonance imaging (MRI) for the prediction of pathologic response after the neoadjuvant chemoradiation (NCRT) for patients with rectalcancer.Materials and MethodsWe retrospectively reviewed the medical records of 524 rectal cancer patients who underwent NCRT and total mesorectal excision between January 2009 and December 2014. The performances of MRI with or without CEA parameters (initial CEA and CEA dynamics) for prediction of pathologic tumor response grade (pTRG) were compared by receiver-operating characteristic analysis with DeLong’s method. Cox regression was used to identify the independent factors associated to pTRG and disease-free survival (DFS) after NCRT.ResultsThe median follow-up was 64.0 months (range, 3.0 to 113.0 months). On multivariate analysis, poor tumor regression grade on MRI (mrTRG; p < 0.001), initial CEA (p < 0.001) and the mesorectal fascia involvement on MRI before NCRT (mrMFI; p=0.054) showed association with poor pTRG. The mrTRG plus CEA parameters showed significantly improved performances in the prediction of pTRG than mrTRG alone. All of mrTRG, mrMFI, and initial CEA were also identified as independent factors associated with DFS. The initial CEA further discriminated DFS in the subgroups with good mrTRG or that without mrMFI.ConclusionThe CEA parameters significantly improved the performance of MRI in the prediction of pTRG after NCRT for patients with rectal cancer. The DFS was further discriminated by initial CEA level in the groups with favorable MRI parameters.
- Subjects :
- Adult
Male
Cancer Research
medicine.medical_specialty
Multivariate analysis
Disease-free survival
Colorectal cancer
030218 nuclear medicine & medical imaging
03 medical and health sciences
0302 clinical medicine
Carcinoembryonic antigen
Pathology
medicine
Humans
Pathologic Response
neoplasms
Aged
Retrospective Studies
Aged, 80 and over
Tumor Regression Grade
biology
medicine.diagnostic_test
Rectal Neoplasms
Proportional hazards model
business.industry
Response
Magnetic resonance imaging
Chemoradiotherapy, Adjuvant
Middle Aged
medicine.disease
Magnetic Resonance Imaging
Total mesorectal excision
Neoadjuvant Therapy
Carcinoembryonic Antigen
Chemoradiation
Oncology
030220 oncology & carcinogenesis
biology.protein
Original Article
Female
Radiology
Neoadjuvant
business
Subjects
Details
- ISSN :
- 20059256 and 15982998
- Volume :
- 52
- Database :
- OpenAIRE
- Journal :
- Cancer Research and Treatment
- Accession number :
- edsair.doi.dedup.....f6beac2a399af519bf022bb67b7285be