Differences in CEA Levels and Nutritional Status in Stage III Rectal Cancer Patients Undergoing Different Types of Therapy
DOI:
https://doi.org/10.64780/jnph.v1i2.78Keywords:
Rectal cancer, Carcinoembryonic Antigen (CEA), Nutritional status, Body Mass Index (BMI), Chemotherapy, Radiotherapy, Surgical therapy, Combined therapyAbstract
Background: Rectal cancer is a type of malignancy with a higher rate of local recurrence compared to colon cancer. Various therapies such as surgery, chemotherapy, and radiotherapy are commonly used for treatment. Monitoring the effectiveness of these therapies can be supported by clinical parameters such as Carcinoembryonic Antigen (CEA) levels and nutritional status measured by Body Mass Index (BMI).
Aims: This study aimed to examine the differences in CEA levels and nutritional status among rectal cancer patients receiving different types of therapies.
Methods: This was an observational analytic study with a cross-sectional design. The sample consisted of 56 patients with stage III rectal cancer at Sultan Agung Islamic Hospital Semarang during the period of 2018-2024. Data were collected from medical records and included patients who received either surgery + chemotherapy (n = 33) or surgery + chemotherapy + radiotherapy (n = 23). CEA levels were analyzed using the Mann-Whitney U test, and nutritional status was analyzed using the Independent Sample T-Test.
Result: The results showed no statistically significant difference in CEA levels between the two therapy groups (p = 0.405). However, a significant difference was found in nutritional status, with patients undergoing radiotherapy showing lower BMI values compared to those without radiotherapy (p = 0.000).
Conclusion: CEA levels did not significantly differ between types of therapy in stage III rectal cancer patients. However, radiotherapy was associated with a significant decline in nutritional status. These findings highlight the importance of integrating nutritional monitoring in the management of rectal cancer patients receiving combined therapy
References
Adha, A. S., Bahtiar, N. W., Ibrahim, I. A., Syarfaini, S., & Nildawati, N. (2021). Analysis of the Relationship between Maternal Parenting and the Incidence of Stunting in Toddlers in Jeneponto Regency. Al GIZZAI: Public Health Nutrition Journal, 71-82. https://doi.org/10.24252/algizzai.v1i2.21825
Adila, A., & Mustika, S. E. (2023). The Relationship of Age and Gender to the Incidence of Colorectal Cancer. STM Medical Journal (Science and Medical Technology),6 (1), Article 1. https://doi.org/10.30743/stm.v6i1.349
Aji, A. S. (2018). The Role of Bile and Nutritional Management for Gallstones Patients. Scientific Journal of Indonesian Nutrition Students, 6(1), 30–34.
AL-Nafakh, Z. M., AL-Dujaili, A. Noori. G., & Rudha, A. R. Mohammed. (2020). Assessment of cancer embryonic antigen (CEA) biomarkers in women with breast cancer disease. AIP Conference Proceedings,2290 (1), 020042. https://doi.org/10.1063/5.0029114
Aswan, N. R., & Hanriko, R. (2023). Risk Factors for Colorectal Cancer. Medical Profession Journal of Lampung,13 (2), Article 2. https://doi.org/10.53089/medula.v13i2.560
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R. L., Torre, L. A., & Jemal, A. (2018). Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA: A Cancer Journal for Clinicians,68 (6), 394-424. https://doi.org/10.3322/caac.21492
Budiono, B. P., Then, J., & Istiadi, H. (2018). Differences in Serum Cea Levels in the Detection of Primary Rectal Cancer and Local Recurrence at Rsup Dr. Kariadi Semarang Period January 2013 - December 2014. Media Medika Muda,2 (2). https://ejournal2.undip.ac.id/index.php/mmm/article/view/2637
Cao, W., Chen, H.-D., Yu, Y.-W., Li, N., & Chen, W.-Q. (2021). Changing profiles of cancer burden worldwide and in China: A secondary analysis of the global cancer statistics 2020. Chinese Medical Journal,134 (7), 783. https://doi.org/10.1097/CM9.0000000000001474
Christiyanty, C., Sulistyarini, W. D., & Sirait, Y. (2021). Phenomenological Study: Quality of Life of Women with Cervical Cancer in Physical Health Aspects. Journal of Wiyata Nursing,2 (1), 91-100. https://doi.org/10.35728/jkw.v2i1.442
Dal Bello, M. G., Filiberti, R. A., Alama, A., Orengo, A. M., Mussap, M., Coco, S., Vanni, I., Boccardo, S., Rijavec, E., Genova, C., Biello, F., Barletta, G., Rossi, G., Tagliamento, M., Maggioni, C., & Grossi, F. (2019). The role of CEA, CYFRA21-1 and NSE in monitoring tumor response to Nivolumab in advanced non-small cell lung cancer (NSCLC) patients. Journal of Translational Medicine,17 (1). https://doi.org/10.1186/s12967-019-1828-0
Erliana, U. D., Kurniasari, F. N., & Ariestiningsih, A. D. (2025). Impact of Nutritional Counseling on Dietary Intake, Nutritional Status and Muscle Mass in Cancer Patients Undergoing Radiotherapy. JOURNAL OF HEALTH AND NUTRITION (JKG),7 (2), 270-278. https://doi.org/10.35451/jkg.v7i2.2657
Feng, F., Tian, Y., Xu, G., Liu, Z., Liu, S., Zheng, G., Guo, M., Lian, X., Fan, D., & Zhang, H. (2017). Diagnostic and prognostic value of CEA, CA19-9, AFP and CA125 for early gastric cancer. BMC Cancer,17 (1), Article 1. https://doi.org/10.1186/s12885-017-3738-y
Gao, Y., Song, P., Li, H., Jia, H., & Zhang, B. (2017). Elevated serum CEA levels are associated with the explosive progression of lung adenocarcinoma harboring EGFR mutations. BMC Cancer,17 (1), Article 1. https://doi.org/10.1186/s12885-017-3474-3
Genia, D. I., Ariani, N., Suharti, N., Syamel, M., Elliyanti, A., & Intan, S. A. (2025). Factors Affecting Survival Rates of Patients Receiving Radiotherapy for Ovarian Cancer: A Systematic Review. EMPIRICAL: Journal of Science, Technology and Health,2 (2), Article 2. https://doi.org/10.62335/empiris.v2i2.1266
Hashiguchi, Y., Muro, K., Saito, Y., Ito, Y., Ajioka, Y., Hamaguchi, T., Hasegawa, K., Hotta, K., Ishida, H., Ishiguro, M., Ishihara, S., Kanemitsu, Y., Kinugasa, Y., Murofushi, K., Nakajima, T. E., Oka, S., Tanaka, T., Taniguchi, H., Tsuji, A., ... Japanese Society for Cancer of the Colon and Rectum. (2020). Japanese Society for Cancer of the Colon and Rectum (JSCCR) guidelines 2019 for the treatment of colorectal cancer. International Journal of Clinical Oncology,25 (1), 1-42. https://doi.org/10.1007/s10147-019-01485-z
Hendrawati, S., Nurhidayah, I., Mediani, H. S., & Mardhiyah, A. (2020). Incident of Mucositis and the Factors that Influence it on Children with Cancer Who Received Chemotherapy. Journal of Nursing,10 (2), 139-150. https://doi.org/10.22219/jk.v10i2.5498
Hester, R., Advani, S., Rashid, A., Holliday, E., Messick, C., Das, P., You, Y.-Q. N., Taniguchi, C., Koay, E. J., Bednarski, B., Rodriguez-Bigas, M., Skibber, J., Wolff, R., Chang, G. J., Minsky, B. D., Foo, W. C., Rothschild, N., Morris, V. K., & Eng, C. (2021). CEA as a blood-based biomarker in anal cancer. Oncotarget,12 (11), 1037. https://doi.org/10.18632/oncotarget.27959
Kankanala, V., Zubair, M., & Mukkamalla, S. K. (2024). Carcinoembryonic Antigen. StatPearls. https://www.statpearls.com/point-of-care/137650
M. Rizki Fazrian Danu & M. Sayuti. (2023a). Management of Colorectal Cancer Management. Detector: Journal of Health Science Research Innovation,1 (4), 159-166. https://doi.org/10.55606/detector.v1i4.2494
M. Rizki Fazrian Danu & M. Sayuti. (2023b). Colorectal Cancer Management. Detector: Journal of Health Science Research Innovation,1 (4), 159-166. https://doi.org/10.55606/detector.v1i4.2494
Masuke, R., Msuya, S. E., Mahande, J. M., Diarz, E. J., Stray-Pedersen, B., Jahanpour, O., & Mgongo, M. (2021). Effect of inappropriate complementary feeding practices on the nutritional status of children aged 6-24 months in urban Moshi, Northern Tanzania: A cohort study. PLOS ONE,16 (5), e0250562. https://doi.org/10.1371/journal.pone.0250562
Muley, T., Rolny, V., He, Y., Wehnl, B., Escherich, A., Warth, A., Stolp, C., Schneider, M. A., Dienemann, H., Meister, M., Herth, F. J., & Dayyani, F. (2018). The combination of the blood-based tumor biomarkers cytokeratin 19 fragments (CYFRA 21-1) and carcinoembryonic antigen (CEA) as a potential predictor of benefit from adjuvant chemotherapy in early stage squamous cell carcinoma of the lung (SCC). Lung Cancer,120 , 46-53. https://doi.org/10.1016/j.lungcan.2018.03.015
Novitasari, A., Puruhita, N., Noer, E. R., & Syauqy, A. (2016). Relationship between Radiotherapy Fraction and Body Composition Index of Cervical Cancer Patients at Rsup Dr. Kariadi Semarang. Journal of Nutrition College,5 (1), 28-35. https://doi.org/10.14710/jnc.v5i1.16356
Piqueras, P., Ballester, A., Durá-Gil, J. V., Martinez-Hervas, S., Redón, J., & Real, J. T. (2021). Anthropometric Indicators as a Tool for Diagnosis of Obesity and Other Health Risk Factors: A Literature Review. Frontiers in Psychology,12 , 631179. https://doi.org/10.3389/fpsyg.2021.631179
Ridwan, D. F. S., & Suryaalamsah, I. I. (2023). The Relationship between Nutritional Status and Nutritional Knowledge with the Incidence of Anemia in Adolescent Girls at SMP Triyasa Ujung Berung Bandung. Muhammadiyah Journal of Midwifery,4 (1), Article 1. https://doi.org/10.24853/myjm.4.1.8-15
Sayuti, M., & Nouva, N. (2019). Colorectal Cancer. AVERROUS: Malikussaleh Journal of Medicine and Health, 76-88. https://doi.org/10.29103/averrous.v5i2.2082
Syakir, S. A., & Zuhan, A. (2024). Colorectal Cancer: The Impact of Smoking and Alcohol on Risk in West Nusa Tenggara, Treatment, and Prevention. Journal of Tropical Biology,24 (1b), 488-497. https://doi.org/10.29303/jbt.v24i1b.8074
Tallulembang, A., Widani, N. L., & Bandur, A. (2021). Nurses' Experience in Providing Nursing Care to Covid-19 Patients in DKI Jakarta. Indonesian Health Promotion Publication Media (MPPKI),4 (1), 74-91. https://doi.org/10.56338/mppki.v4i1.1392
Wijaya, A. P., Juliantara, I. P. E., & Fikli, D. (2024). Analysis of the Effectiveness of Using Orfit Base Plate in Breast Cancer Cases in Prone Position with Intensity Modulated Radiotherapy (IMRT) Technique at Radiotherapy Installation of East Jakarta Regional Hospital. Journal of Health and Nutrition Sciences,2 (1), 199-215. https://doi.org/10.55606/jikg.v2i1.2150
Yulideswati, Y., & Nurbaiti, N. (2024). Review of Body Mass Index (BMI) on Geometry Verification in Cervical Cancer 3DCRT Technique. Medical Profession Journal of Lampung,14 (1), 167-173. https://doi.org/10.53089/medula.v14i1.916
Yuniarly, E., Amalia, R., & Haryani, W. (2019). The relationship between the level of knowledge about oral health and the level of dental and oral hygiene of elementary school children. Journal of Oral Health Care,7 (1), Article 1. https://doi.org/10.29238/ohc.v7i1.339