Positive postoperative CEA is a strong predictor of recurrence for patients after resection for colorectal liver metastases Journal Article
| Authors: | Araujo, R. L. C. ; Gönen, M.; Allen, P.; DeMatteo, R.; Kingham, P.; Jarnagin, W.; D'Angelica, M.; Fong, Y. |
| Article Title: | Positive postoperative CEA is a strong predictor of recurrence for patients after resection for colorectal liver metastases |
| Abstract: | 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. © 2015, Society of Surgical Oncology. |
| Keywords: | survival; adult; controlled study; aged; major clinical study; cancer recurrence; postoperative period; fluorouracil; cancer combination chemotherapy; cancer adjuvant therapy; recurrence risk; follow up; lymph node dissection; carcinoembryonic antigen; retrospective study; irinotecan; liver resection; disease free interval; oxaliplatin; predictive value; colorectal liver metastasis; human; male; female; article |
| Journal Title: | Annals of Surgical Oncology |
| Volume: | 22 |
| Issue: | 9 |
| ISSN: | 1068-9265 |
| Publisher: | Springer |
| Date Published: | 2015-09-01 |
| Start Page: | 3087 |
| End Page: | 3093 |
| Language: | English |
| DOI: | 10.1245/s10434-014-4358-2 |
| PROVIDER: | scopus |
| PMCID: | PMC4526451 |
| PUBMED: | 25582745 |
| DOI/URL: | |
| Notes: | Export Date: 2 September 2015 -- Source: Scopus |
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