<![CDATA[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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