Clinical

Low CEA after resection of colorectal liver metastases predicts better survival odds

Last Updated: 2008-12-30 16:07:51 -0400 (Reuters Health)

NEW YORK (Reuters Health) - Patients with the lowest carcinoembryonic antigen (CEA) levels after liver resection for colorectal metastases have the highest survival rates, according to a report in the December issue of the Archives of Surgery.

CEA blood level is the most commonly used tumor marker to monitor patients after resection of primary colorectal cancer and colorectal liver metastases, the authors explain, but few studies have investigated its prognostic value among patients undergoing resection of colorectal liver metastases.

Dr. Daniel Jaeck from Hopitaux Universitaires de Strasbourg-Universite Louis Pasteur, Strasbourg, France, and colleagues evaluated the value of CEA measurements obtained a week before and 6 weeks after surgery to predict cure after resection of colorectal liver metastases in 213 patients.

Five-year overall and disease-free survival rates were highest (50.2% and 21.9%, respectively) among patients with normal preoperative and postoperative CEA levels, the authors report. They were lower (38.5% and 18.3%, respectively) for patients with elevated preoperative and normal postoperative CEA levels, and lowest (0.0% and 0.0%, respectively) for patients with elevated preoperative and postoperative CEA levels.

"Normalization of CEA levels 6 weeks after colorectal liver metastases resection may indicate improved long-term outcomes in these patients," the investigators say.

"CEA levels as early as 6 weeks after surgery may be helpful in assigning patients to adjuvant chemotherapy after resection of colorectal liver metastases," the authors conclude.

Arch Surg 2008;143:1150-1158.