Prognostic value of postoperative carcinoembryonic antigen concentration and extent of invasion of resection margins after hepatic resection for colorectal metastases.
OBJECTIVE
To evaluate the prognostic value of postoperative concentration of carcinoembryonic antigen (CEA) and extent of surgical margins after resection of liver metastases from colorectal cancer.


METHODS
Retrospective study.


METHODS
Teaching hospital, Switzerland.


METHODS
49 patients with hepatic metastases after primary colorectal cancer.


METHODS
Resection of hepatic metastases


METHODS
Assessment of prognostic value of variables by univariate and multivariate analysis.


RESULTS
Median survival was 24 months (range 5-86 months). Resection margins were clear (> 1-cm) in 10, close (< 1-cm) in 25 and invaded in 9 patients. On univariate analysis, a postoperative concentration of CEA of <4ng/ml was correlated with prolonged survival (p < 0.001), but the width of the resection margin was not of prognostic importance. There was no correlation between width of resection margins and postoperative concentration of CEA (p = 0.5). On multivariate analysis, postoperative concentrations of CEA of 4 ng/ml or more were associated with increased risk of death (relative risk 7.3; 95% confidence interval (CI) 2.8-18.7, p < 0.001).


CONCLUSIONS
Postoperative CEA offers better prognostic discrimination than the width of resection margins after resection of liver metastases from colorectal tumours. Some patients with invaded resection margins did survive for 3 years, but no patient did whose CEA concentration was 4 ng/ml or more. The definition of a potentially curative hepatic resection should include a postoperative CEA concentration of <4 ng/ml (within the reference range).
Gervaz
P
P
Department of Surgery, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland.
Blanchard
A
A
Pampallona
S
S
Mach
J P
JP
Fontolliet
C
C
Gillet
M
M
D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D008297:Male; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness; D011184:Postoperative Period; D011237:Predictive Value of Tests; D011379:Prognosis; D016019:Survival Analysis
D002272:Carcinoembryonic Antigen