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- W2591470147 abstract "403 Background: The objective of the present investigation was to assess whether elevated pre-operative CEA level represents a significant predictor for decreased overall survival in stage I-III rectal cancer patients. Methods: The present study is based on the colorectal database of the authors` hospital, one of the largest tertiary care centers of Switzerland. All patients undergoing a resection for stage I - III rectal cancer were consecutively included between 1991 and 2008. Average follow-up time was 50.3 months. The impact of pre-operative CEA on overall survival was assessed in Cox proportional hazard regression analyses after risk-adjusting for age, gender, body mass index, performance status, tumor stage, tumor distance from the anal verge, and neoadjuvant treatment. Pre-operative CEA levels were classified as normal (< 5 µg/liter) versus elevated (>5 µg/liter). All tests were two-sided, the level of statistical significance was set at 0.05. Results: Overall, 534 consecutive patients undergoing resection for stage I - III rectal cancer were included. Median age was 65 years (range 24 to 91 years), 62% of patients were male, median ASA was II (range I – IV), median body mass index 25.3 kg/m 2 (range 15.4 to 44.9 kg/m 2 ). Pre-operative CEA levels were elevated in 21.7% of all patients. After risk-adjusting in Cox proportional hazard regression analyses pre-operative CEA level (p<0.001; odds ratio: 2.020), distance from the anal verge <5cm (p<0.001, odds ratio: 2.434), older age (p<0.001; odds ratio: 1.069) and higher tumor stage (p=0.004, odds ratio: 2.003) were all significant predictors for poor overall survival. Forward- and backward variable selection including bootstrap analyses confirmed these results. Conclusions: The present investigation based on a large cohort of consecutive stage I – III rectal cancer patients provides compelling evidence that elevated pre-operative CEA level is a strong predictor of decreased overall survival even after risk-adjusting in Cox proportional hazard regression analyses. Therefore, it is crucial that pre-operative CEA is used as a prognostic factor in the pre-operative assessment of stage I-III rectal cancer patients." @default.
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- W2591470147 date "2012-02-01" @default.
- W2591470147 modified "2023-10-18" @default.
- W2591470147 title "Is elevated preoperative CEA level a significant predictor for decreased overall survival in patients with stage I to III rectal cancer?" @default.
- W2591470147 doi "https://doi.org/10.1200/jco.2012.30.4_suppl.403" @default.
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