Evidence map›Paper›PMID 38270826›Full record

ArticleAnnals of surgical oncology2024

Normal CEA Levels After Neoadjuvant Chemotherapy and Cytoreduction with Hyperthermic Intraperitoneal Chemoperfusion Predict Improved Survival from Colorectal Peritoneal Metastases.

Michael M Wach, Geoffrey Nunns, Ahmed Hamed, Joshua Derby, Mark Jelinek, Curtis Tatsuoka, Matthew P Holtzman, Amer H Zureikat, David L Bartlett, Steven A Ahrendt and 3 more

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Article in Annals of surgical oncology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
5.2field-weighted citation impact, top 4% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed, 9 citations in OpenAlex.

  1. Review
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 3 institutions in 1 country.

Michael M WachDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Geoffrey NunnsDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Ahmed HamedDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Joshua DerbyDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Mark JelinekDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Curtis TatsuokaDepartment of Medicine, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Matthew P HoltzmanDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Amer H ZureikatDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
David L BartlettAHN Cancer Institute, Allegheny Health Network, Pittsburgh, PA, USA.
Steven A AhrendtDepartment of Surgery, University of Colorado, Aurora, CO, USA.
James F PingpankDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
M Haroon A ChoudryDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA.
Melanie OngchinDepartment of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA, USA. ongchinmc3@upmc.edu.
University of Pittsburgh Medical Center · USAllegheny Health Network · USUniversity of Colorado Anschutz Medical Campus · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundNormal carcinoembryonic antigen (CEA) levels (≤ 2.5 ng/ml) after resection of localized colorectal cancer or liver metastases are associated with improved survival, however, these trends are understudied for colorectal peritoneal metastases (CRPM). PATIENTS AND

methodsWe conducted a retrospective single-institution study of patients with CRPM undergoing cytoreductive surgery with hyperthermic intraperitoneal chemoperfusion (CRS/HIPEC) with and without neoadjuvant chemotherapy (NACT). CEA was measured before and after NACT and within 3 months after CRS/HIPEC.

resultsA total of 253 patients (mean age 55.3 years) with CRPM undergoing CRS/HIPEC had complete CEA data and 191 also underwent NACT with complete data. The median peritoneal carcinomatosis index score (PCI) of the overall cohort was 12 and 82.7% of patients had complete cytoreduction (CC0). In total, 64 (33.5%) patients had normal CEA levels after NACT with a median overall survival (OS) of 45.2 months compared with those with an elevated CEA (26.4 months, p = 0.004). Patients with normal CEA after NACT had a lower PCI found at the time of surgery than those with elevated CEA (10 versus 14, p < 0.001), 68 (26.9%) patients with an elevated preoperative CEA level experienced normalization after CRS/HIPEC, and 118 (46.6%) patients had elevated CEA after CRS/HIPEC. Patients who experienced normalization demonstrated similar OS to patients that had normal CEA levels pre- and post-surgery and improved OS compared with those with elevated postop CEA (median 41.9 versus 47 months versus 17.1 months, respectively, p < 0.001).

conclusionsNormal CEA levels after NACT and/or CRS/HIPEC are associated with improved survival for patients with CRPM. Patients that normalize CEA levels after surgery have similar survival to those with normal preoperative levels.

Indexed as

Colorectal NeoplasmsHyperthermia, InducedPeritoneal NeoplasmsAntineoplastic Combined Chemotherapy ProtocolsCarcinoembryonic AntigenCombined Modality TherapyCytoreduction Surgical ProceduresHumansMiddle AgedNeoadjuvant TherapyRetrospective StudiesSurvival RateCarcinoembryonic AntigenCarcinoembryonic antigenColorectal cancerColorectal peritoneal metastasesPeritoneal carcinomatosis

Identifiers

PMID38270826
OpenAlexW4391232899

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.