DOI: https://doi.org/10.14710/dmj.v15i2.53103

IMPACT OF CHEMOTHERAPY, SURGERY, AND RADIOTHERAPY ON COLORECTAL CANCER PATIENTS: A MULTIFACETED PERSPECTIVE

Vito Mahendra Ekasaputra orcid  -  Department of Surgery, Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia, Indonesia
Abdullah Rizky  -  Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia, Indonesia
*Linailil 'Ulya  -  Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia, Indonesia
Ragita Shabrina  -  Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia, Indonesia
Chodidjah Chodidjah orcid  -  Department of Anatomy, Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia, Indonesia
Eko Setiawan orcid  -  Department of Surgery, Faculty of Medicine, Universitas Islam Sultan Agung, Semarang, Indonesia, Indonesia
Open Access Copyright 2026 Vito Mahendra Ekasaputra, Abdullah Rizky, Linailil 'Ulya, Ragita Shabrina, Chodidjah Chodidjah, Eko Setiawan
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

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Abstract

Background: Colorectal cancer is a major contributor to cancer-related morbidity and mortality. Multimodal treatment approaches, such as surgery, chemotherapy, and radiotherapy, aim to improve survival and quality of life, yet their impact on various clinical outcomes in Indonesian patients remains underexplored. Objective: This study examines the impact of different treatment modalities on carcinoembryonic antigen (CEA) levels, nutritional status, pain, functional status, and survival in advanced-stage colorectal cancer patients. Methods: This retrospective cross-sectional study reviewed medical records of stage III patients aged 19–64 years treated between 2018 and 2024 at two Central Java hospitals. CEA was measured from serum via ELISA, nutritional status by body mass index (BMI), pain by Numerical Rating Scale (0–10), and functional status by Karnofsky Performance Index (0–100%). Mann–Whitney U and Fisher’s Exact tests were applied (p < 0.05). Results: BMI was lower in the surgery + chemotherapy + radiotherapy group compared with surgery + chemotherapy alone (median 18.6 vs. 20.5 kg/m², p = 0.04). Neoadjuvant + adjuvant chemotherapy was associated with lower postoperative CEA levels (2.6 vs. 7.5 ng/mL, p = 0.02) and higher one-year survival (96% vs. 88%) and higher one-year survival (96% vs. 88%), although this difference was not statistically significant. Pain was lower in the neoadjuvant-only group than in the neoadjuvant + adjuvant group (median NRS 2 vs. 4, p = 0.03), while functional status remained high (>70%) across groups. Conclusion: Neoadjuvant chemotherapy showed favorable trends in CEA reduction, survival, and pain control, while chemoradiotherapy was linked to poorer nutritional status. Despite limitations, these findings provide context-specific evidence to inform multimodal treatment strategies in Indonesia.

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Keywords: Carcinoembryonic Antigen;Chemotherapy;Colorectal Cancer

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Language : EN
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  9. Setia M. Methodology series module 3: Cross-sectional studies. Indian J Dermatol [Internet]. 2016;61(3):261. Available from: https://journals.lww.com/10.4103/0019-5154.182410
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  12. Auclin E, Taieb J, Lepage C, Aparicio T, Faroux R, Mini E, et al. Carcinoembryonic Antigen Levels and Survival in Stage III Colon Cancer: Post hoc Analysis of the MOSAIC and PETACC-8 Trials. Cancer Epidemiol Biomarkers Prev. 2019 Jul 1;28(7):1153–61
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  14. Daniele A, Divella R, Abbate I, Casamassima A, Garrisi VM, Savino E, et al. Assessment of Nutritional and Inflammatory Status to Determine the Prevalence of Malnutrition in Patients Undergoing Surgery for Colorectal Carcinoma. Anticancer Res. 2017 Mar 17;37(3):1281–8
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  17. Yamano T, Tomita N, Sato T, Hayakawa K, Kamikonya N, Matoba S, et al. Influence of chemoradiotherapy on nutritional status in locally advanced rectal cancer: Prospective multicenter study. Nutrition. 2020 Sep;77:110807
  18. Ramphal W, Boeding JRE, van Iwaarden M, Schreinemakers JMJ, Rutten HJT, Crolla RMPH, et al. Serum carcinoembryonic antigen to predict recurrence in the follow-up of patients with colorectal cancer. Int J Biol Markers. 2019 Mar 11;34(1):60–8
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  21. Shinkins B, Nicholson BD, James T, Pathiraja I, Pugh S, Perera R, et al. What carcinoembryonic antigen level should trigger further investigation during colorectal cancer follow-up? A systematic review and secondary analysis of a randomised controlled trial. Health Technol Assess (Rockv). 2017 Apr;21(22):1–60
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  24. NCNN. NCCN Clinical Practice Guidelines in Oncology: Colon Cancer [Internet]. 5th ed. 2024. Available from: https://www.nccn.org/guidelines/guidelines-detail?category=1&id=1428

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