Significance of postoperative serum carcinoembryonic antigen combined with tumor deposition in Stage II-III Colon Cancer Patients: a retrospective multicenter cohort study

Abstract Purpose This study aimed to investigate postoperative CEA combined with tumor deposition for risk stratification of postoperative recurrence of stage II-III colon cancer. Methods A retrospective analysis of 761 patients who underwent radical surgery for stage II-III colon cancer from April 2008 to January 2019. Patients were grouped into 3 cohorts: normal postoperative CEA without tumor deposits(TD), normal postoperative CEA with TD, and elevated postoperative CEA. Cox proportional hazards regression model was used to analyze the independent recurrence prognostic factors of patients with recurrence-free survival (RFS). The Kaplan-Meier method was used to draw the patient's RFS curve. Results The median follow-up period of all patients was 49.73 months. A total of 761 patients (452 [59.4%] male; median [IQR] age, 69 [50–67] years) were identified. The 3-year RFS of 60 patients with normal postoperative CEA and positive TD was 51.1% (95% CI, 39.8%-65.5%), and the 3-year RFS of 103 patients with elevated postoperative CEA was 47.7% (95% CI, 38.5%-58.3%). (Patients with normal postoperative CEA and positive TD vs Patients with elevated postoperative CEA: HR, 1.04; 95% CI, 0.67–1.60; P = 0.877). Multivariate analysis of the COX proportional hazards model showed that normal postoperative CEA with TD (HR, 2.0; 95% CI, 1.1–3.5) is independently associated with shorter RFS. Conclusion Patients with normal postoperative CEA still have a higher risk of recurrence if combined with tumor deposits. It is necessary to incorporate postoperative CEA and tumor deposition into high-risk factors for postoperative recurrence of colon cancer for management.