Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke.

Serum carcinoembryonic antigen (CEA) levels can help predict the prognosis of colorectal cancer patients. Accordingly, high preoperative CEA levels that is not restored after surgery are indicative of a worse outcome. On the other hand, smoking can increase serum CEA levels independently of the dise...

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Main Authors: Chih-Sheng Huang, Chin-Yau Chen, Li-Kuo Huang, Wei-Shu Wang, Shung-Haur Yang
Format: Article
Language:English
Published: Public Library of Science (PLoS) 2020-01-01
Series:PLoS ONE
Online Access:https://doi.org/10.1371/journal.pone.0233687
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author Chih-Sheng Huang
Chin-Yau Chen
Li-Kuo Huang
Wei-Shu Wang
Shung-Haur Yang
author_facet Chih-Sheng Huang
Chin-Yau Chen
Li-Kuo Huang
Wei-Shu Wang
Shung-Haur Yang
author_sort Chih-Sheng Huang
collection DOAJ
description Serum carcinoembryonic antigen (CEA) levels can help predict the prognosis of colorectal cancer patients. Accordingly, high preoperative CEA levels that is not restored after surgery are indicative of a worse outcome. On the other hand, smoking can increase serum CEA levels independently of the disease status. Thus, we aimed to evaluate the impact of smoking on the prognostic value of serum CEA levels. This retrospective cohort study included 273 patients who underwent curative resection for stage I-III colorectal adenocarcinoma at a single institution, between January 2010 and December 2017. Patients were grouped as follows: group A, normal preoperative and postoperative CEA levels (n = 152); group B, elevated preoperative CEA levels that returned to reference values after surgery (n = 69); and group C, elevated postoperative serum CEA levels (n = 52). Patients were also grouped according to their smoking history: group S (current smokers, n = 79) and group NS (never and former smokers, n = 194). Group A showed a higher 3-year disease-free survival (DFS) rate (84.9%) than groups B (75.4%) and C (62.0%) (p < 0.001). Postoperative serum CEA levels were significantly higher in the S group than in the NS group (2.6 vs. 3.1 ng/mL, p = 0.009), whereas preoperative levels were similar (3.8 vs. 4.1, p = 0.182). Further, smokers showed higher 3 year-DFS rates than nonsmokers in group C (83.3% vs. 43.9%, p = 0.029). This suggests that while elevated postoperative CEA levels are associated with lower DFS rates in never and former smokers, they are not associated with lower DFS rates in current smokers. We conclude that persistent smoking alters the prognostic value of postoperative serum CEA levels in colorectal cancer patients and that, consequently, alternative surveillance strategies need to be developed for colon cancer patients with smoking habits.
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spelling doaj.art-5dc8327a6e38450ebc17a4c50a43bb3a2022-12-21T23:09:18ZengPublic Library of Science (PLoS)PLoS ONE1932-62032020-01-01156e023368710.1371/journal.pone.0233687Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke.Chih-Sheng HuangChin-Yau ChenLi-Kuo HuangWei-Shu WangShung-Haur YangSerum carcinoembryonic antigen (CEA) levels can help predict the prognosis of colorectal cancer patients. Accordingly, high preoperative CEA levels that is not restored after surgery are indicative of a worse outcome. On the other hand, smoking can increase serum CEA levels independently of the disease status. Thus, we aimed to evaluate the impact of smoking on the prognostic value of serum CEA levels. This retrospective cohort study included 273 patients who underwent curative resection for stage I-III colorectal adenocarcinoma at a single institution, between January 2010 and December 2017. Patients were grouped as follows: group A, normal preoperative and postoperative CEA levels (n = 152); group B, elevated preoperative CEA levels that returned to reference values after surgery (n = 69); and group C, elevated postoperative serum CEA levels (n = 52). Patients were also grouped according to their smoking history: group S (current smokers, n = 79) and group NS (never and former smokers, n = 194). Group A showed a higher 3-year disease-free survival (DFS) rate (84.9%) than groups B (75.4%) and C (62.0%) (p < 0.001). Postoperative serum CEA levels were significantly higher in the S group than in the NS group (2.6 vs. 3.1 ng/mL, p = 0.009), whereas preoperative levels were similar (3.8 vs. 4.1, p = 0.182). Further, smokers showed higher 3 year-DFS rates than nonsmokers in group C (83.3% vs. 43.9%, p = 0.029). This suggests that while elevated postoperative CEA levels are associated with lower DFS rates in never and former smokers, they are not associated with lower DFS rates in current smokers. We conclude that persistent smoking alters the prognostic value of postoperative serum CEA levels in colorectal cancer patients and that, consequently, alternative surveillance strategies need to be developed for colon cancer patients with smoking habits.https://doi.org/10.1371/journal.pone.0233687
spellingShingle Chih-Sheng Huang
Chin-Yau Chen
Li-Kuo Huang
Wei-Shu Wang
Shung-Haur Yang
Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke.
PLoS ONE
title Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke.
title_full Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke.
title_fullStr Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke.
title_full_unstemmed Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke.
title_short Prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke.
title_sort prognostic value of postoperative serum carcinoembryonic antigen levels in colorectal cancer patients who smoke
url https://doi.org/10.1371/journal.pone.0233687
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