title: Perioperative carcinoembryonic antigen measurements to predict curability after liver resection for colorectal metastases: a prospective study.
abstract: OBJECTIVE
  Perioperative carcinoembryonic antigen (CEA) blood level is a predictor of outcome after resection of colorectal liver metastases (CLMs).
  
  
  METHODS
  Prospective clinical study.
  
  
  METHODS
  Department of digestive surgery and transplantation.
  
  
  METHODS
  Between January 1, 2000, and December 31, 2004, CEA levels were routinely measured 1 week before and 6 weeks after CLM resection in 213 patients. The patients were divided into the following 3 groups: group A (n = 69) with normal preoperative and postoperative CEA levels, group B (n = 111) with elevated preoperative and normal postoperative CEA levels, and group C (n = 33) with elevated preoperative and postoperative CEA levels.
  
  
  METHODS
  The use of perioperative CEA levels to predict outcome after resection.
  
  
  RESULTS
  The median survival was 45.4 months. The 5-year overall and disease-free survival rates were 50.2% and 21.9%, respectively, in group A, 38.5% and 18.3% in group B, and 0.0% and 0.0% in group C (P < .001). Univariate analysis showed that patients with elevated preoperative and postoperative CEA levels, multiple CLMs, large CLMs (> or =5 cm), advanced Fong clinical risk score, bilobar distribution, and hepatic pedicle lymph node involvement had significantly poorer overall and disease-free survival. By multivariate analysis, only perioperative CEA level, hepatic pedicle lymph node involvement, and number and size of CLMs were independent prognostic factors. The 5-year survival rates showed good correlation with perioperative CEA levels in all 3 patient groups.
  
  
  CONCLUSIONS
  The predictive value of perioperative CEA levels is demonstrated. Carcinoembryonic antigen levels as early as 6 weeks after surgery may be helpful in assigning patients to adjuvant chemotherapy after resection of CLMs.
authors.affiliation: Centre de Chirurgie Viscérale et de Transplantation, Hôpital de Hautepierre, Université Louis Pasteur, Strasbourg, France.
authors.forename: Elie
authors.initials: E
authors.lastname: Oussoultzoglou
authors.forename: Edoardo
authors.initials: E
authors.lastname: Rosso
authors.forename: Pascal
authors.initials: P
authors.lastname: Fuchshuber
authors.forename: Victor
authors.initials: V
authors.lastname: Stefanescu
authors.forename: Bala
authors.initials: B
authors.lastname: Diop
authors.forename: Giorgio
authors.initials: G
authors.lastname: Giraudo
authors.forename: Patrick
authors.initials: P
authors.lastname: Pessaux
authors.forename: Philippe
authors.initials: P
authors.lastname: Bachellier
authors.forename: Daniel
authors.initials: D
authors.lastname: Jaeck
mesh_terms: D000368:Aged; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000473:pathology*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011182:Postoperative Care; D011237:Predictive Value of Tests; D011300:Preoperative Care; D011446:Prospective Studies
chemical_list: D002272:Carcinoembryonic Antigen