Positive postoperative CEA is a strong predictor of recurrence for patients after resection for colorectal liver metastases.

Published

Journal Article

BACKGROUND: The role of carcinoembryonic antigen (CEA) in surveillance and follow-up of patients with colorectal cancer continues to be debated. The objective of this study was to assess the utility of postoperative CEA as a predictor of recurrence for patients with resected colorectal liver metastases (CLM). METHODS: Patients were identified from a prospectively maintained CLM database, and were studied retrospectively. Patients with extrahepatic disease or initially unresectable CLM were excluded. All patients in this study received adjuvant systemic chemotherapy after resection. RESULTS: Between 1997 and 2007, a total of 318 consecutive patients were studied, with 168 patients (53 %) experiencing recurrence within 2 years. Various postoperative CEA cutoffs were tested as independent predictors of recurrence. A postoperative CEA ≥15 ng/ml obtained the highest hazard ratio (1.87; 95 % CI 1.09-3.2; p = 0.023) and was chosen to be included in the survival analysis in the multivariate model. A postoperative CEA ≥15 ng/ml had a specificity of 96 % and positive predictive value of 82 % for recurrence. On multivariate analysis, age ≥70 years, the presence of positive lymph node at primary tumor resection, disease-free interval ≤12 months, number of lesions >1, largest lesion ≥5 cm, presence of positive margins, and postoperative CEA ≥15 ng/ml were independent predictors of recurrence within 2 years. CONCLUSION: This study demonstrates a postoperative CEA ≥15 ng/ml to be a predictive test for recurrence.

Full Text

Duke Authors

Cited Authors

  • Araujo, RLC; Gönen, M; Allen, P; DeMatteo, R; Kingham, P; Jarnagin, W; D'Angelica, M; Fong, Y

Published Date

  • September 2015

Published In

Volume / Issue

  • 22 / 9

Start / End Page

  • 3087 - 3093

PubMed ID

  • 25582745

Pubmed Central ID

  • 25582745

Electronic International Standard Serial Number (EISSN)

  • 1534-4681

Digital Object Identifier (DOI)

  • 10.1245/s10434-014-4358-2

Language

  • eng

Conference Location

  • United States