Prognostic impact of carcinoembryonic antigen (CEA) on patients with metastatic pancreatic cancer: A retrospective cohort study

Background: Carcinoembryonic antigen (CEA) is one of the most widely used tumor markers, and its level is increased in 30-60% of patients with pancreatic cancer (PC). However, little is known about the implications of CEA as a prognostic marker in metastatic PC. The purpose of this study was to examine the usefulness of CEA levels as a prognostic marker in patients with metastatic PC. Methods: We conducted a retrospective cohort study using data from a computerized database. A total of 433 patients with metastatic disease were analyzed. Results: Median overall survival (OS) was significantly shorter for patients with high CEA (>5 ng/ml) than with normal CEA (<= 5 ng/ml) (6.8 vs. 103 months, respectively; p < 0.001). After adjustment, CEA level was an independent predictive factor for OS (hazard ratio II-In 1.81; 95% confidence interval [CI], 1.45 -2.26). In the high CEA group, OS in patients treated with combination chemotherapy was similar to that with single-agent chemotherapy (median, 7.1 vs. 6.8 months; HR for OS, 0.99; 95% CI, 0.71-1.40). Conclusions: The present results show that CEA level is an independent prognostic factor in patients with metastatic PC. A combination chemotherapy regimen may offer modest survival benefit in patients with high CEA. (C) 2016 IAP and EPC. Published by Elsevier B.V. All rights reserved.