• Chan Wook Kim, Yong Sik Yoon, In Ja Park, Seok-Byung Lim, Chang Sik Yu, and Jin Cheon Kim.
• Department of Surgery, Institute of Innovative Cancer Research, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
• Ann. Surg. Oncol. 2013 Sep 1; 20 (9): 2914-20.

PurposeTo evaluate stage IIA colorectal cancer in terms of recurrence so as to discover whether high preoperative serum carcinoembryonic antigen (s-CEA) levels indicate that the patient should be included in a high-risk group in stage II colorectal cancer.MethodsWe retrospectively reviewed the records of 1543 patients with stage IIA colorectal cancer who underwent curative surgery between January 2000 and December 2007.ResultsThe 5-year disease-free survival and overall survival rates were significantly lower in patients with a higher than normal preoperative s-CEA (90.5% vs. 82.5%, P<0.001, and 92.4% vs. 87.8%, P=0.034, respectively). Multivariate analysis revealed that elevated preoperative s-CEA level, preoperative obstruction, rectal cancer, and dissection of fewer than 12 nodes were independent statistically significant prognostic factors that predicted disease-free survival in patients with stage IIA disease after curative resection.ConclusionsElevated preoperative s-CEA concentration is a reliable predictor of recurrence after curative resection in patients with stage IIA colorectal cancer. Patients with stage IIA disease with elevated preoperative s-CEA level do worse than those with normal levels and might constitute a group to evaluate for adjuvant chemotherapy. Further studies on the effect of adjuvant chemotherapy in this group are needed.

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