Zheng WT, Li GY. Letter to the Editor: Role of perioperative carcinoembryonic Antigen in guiding adjuvant chemotherapy for colorectal cancer. World J Clin Oncol 2026; 17(8): 122727 [DOI: 10.5306/wjco.122727]
Corresponding Author of This Article
Guang-Yao Li, Associate Chief Physician, Department of Gastrointestinal Surgery, The Second People’s Hospital of Wuhu, 259 Jiuhua Middle Road, Jinghu District, Wuhu 241000, Anhui Province, China. liguangyao@whsdermyy23.wecom.work
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Oncology
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letter
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Zheng WT, Li GY. Letter to the Editor: Role of perioperative carcinoembryonic Antigen in guiding adjuvant chemotherapy for colorectal cancer. World J Clin Oncol 2026; 17(8): 122727 [DOI: 10.5306/wjco.122727]
World J Clin Oncol. Aug 24, 2026; 17(8): 122727 Published online Aug 24, 2026. doi: 10.5306/wjco.122727
Letter to the Editor: Role of perioperative carcinoembryonic Antigen in guiding adjuvant chemotherapy for colorectal cancer
Wen-Ting Zheng, Guang-Yao Li
Wen-Ting Zheng, Second Clinical College, Anhui Medical University, Hefei 230000, Anhui Province, China
Guang-Yao Li, Department of Gastrointestinal Surgery, The Second People’s Hospital of Wuhu, Wuhu 241000, Anhui Province, China
Author contributions: Zheng WT wrote the original draft; Li GY contributed to conceptualization, writing, reviewing and editing; and all authors have read and approved the final version of the manuscript.
AI contribution statement: The authors take full responsibility and accountability for all content of this manuscript, including any portions for which AI tools were used as assistive technologies. All AI-assisted outputs were carefully reviewed, validated, and approved by the authors. AI tools were not used to generate original scientific data, perform independent scientific analyses, or draw scientific conclusions.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
Corresponding author: Guang-Yao Li, Associate Chief Physician, Department of Gastrointestinal Surgery, The Second People’s Hospital of Wuhu, 259 Jiuhua Middle Road, Jinghu District, Wuhu 241000, Anhui Province, China. liguangyao@whsdermyy23.wecom.work
Received: April 27, 2026 Revised: July 11, 2026 Accepted: July 20, 2026 Published online: August 24, 2026 Processing time: 121 Days and 0 Hours
Abstract
Du et al reported that postoperative carcinoembryonic antigen (CEA) may serve as a cost-effective marker to guide adjuvant chemotherapy in colorectal cancer. Although this study provides clinically relevant findings, several issues need further discussion. First, the retrospective design limits causal interpretation and remains susceptible to selection bias and unmeasured confounding, particularly in non-randomized treatment allocation. Second, the definition and timing of postoperative CEA measurement may influence its predictive value, given its short half-life and potential interference from perioperative factors. Third, the clinical application of CEA-guided treatment requires more rigorous evaluation, including formal interaction testing and consideration of treatment toxicity. Integrating postoperative CEA with emerging biomarkers such as circulating tumor DNA could improve risk stratification. Further prospective studies are needed to validate these findings and clarify their clinical utility.
Core Tip: Postoperative carcinoembryonic antigen (CEA) is a simple and inexpensive marker, but its use for guiding adjuvant chemotherapy in colorectal cancer still requires caution. The retrospective design, variable timing of postoperative CEA testing, and absence of treatment–biomarker interaction analysis may limit the strength of the conclusion. Future studies should standardize CEA measurement and combine it circulating tumor DNA to improve postoperative risk stratification.
