title: Post-chemotherapeutic CEA and CA19-9 are prognostic factors in patients with colorectal liver metastases treated with hepatic resection after oxaliplatin-based chemotherapy.
abstract: OBJECTIVE
  The prognostic value of tumor markers remains unclear in patients with colorectal liver metastases (CRLM) who undergo hepatectomy following chemotherapy. The aim of the present study was to identify prognostic factors associated with recurrence and survival in such patients.
  
  
  METHODS
  Between 2005 and 2012, 62 patients with initially unresectable or marginally unresectable CRLM who underwent hepatectomy following chemotherapy were enrolled. A Cox proportional hazards model was used to identify the prognostic factors.
  
  
  RESULTS
  Multivariate analysis indicated that a high level of carbohydrate antigen 19-9 (CA19-9) in serum post-chemotherapy was significant factor, predictive of poor overall survival [Hazard Ratio (HR)=4.46, 95% Confidence Interval (CI)=1.68-11.8; p=0.003] and marginally significant regarding poorer relapse-free survival (HR=2.11, 95% CI=0.99-4.47; p=0.050). Non-response to preoperative chemotherapy was a significant prognostic factor regarding shorter relapse-free (HR=2.18, 95% CI=1.10-4.33; p=0.026) and overall survival (HR=3.14, 95% CI=1.22-8.08; p=0.018). High levels of carcinoembryonic antigen CEA in serum post-chemotherapy (HR=3.08, 95% CI=1.13-8.39; p=0.028) and the absence of adjuvant chemotherapy (HR=2.27, 95% CI=1.17-4.41; p=0.016) were independent risk factors for recurrence.
  
  
  CONCLUSIONS
  Measurement of both CEA and CA19-9 level is strongly recommended for patients with CRLM treated with preoperative chemotherapy followed by hepatectomy because normalization of serum CEA and CA19-9 levels after chemotherapy will demonstrate a good prognosis after curative hepatectomy.
authors: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan Department of Multidisciplinary Treatment for Gastroenterological Cancer, Kumamoto University Hospital, Kumamoto, Japan.
authors: Yasuo
authors: Y
authors: Sakamoto
authors: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors: Yuji
authors: Y
authors: Miyamoto
authors: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan Department of Multidisciplinary Treatment for Gastroenterological Cancer, Kumamoto University Hospital, Kumamoto, Japan.
authors: Toru
authors: T
authors: Beppu
authors: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors: Hidetoshi
authors: H
authors: Nitta
authors: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors: Katsunori
authors: K
authors: Imai
authors: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors: Hiromitsu
authors: H
authors: Hayashi
authors: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors: Yoshifumi
authors: Y
authors: Baba
authors: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors: Naoya
authors: N
authors: Yoshida
authors: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan.
authors: Akira
authors: A
authors: Chikamoto
authors: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, Kumamoto, Japan hdobaba@kumamoto-u.ac.jp.
authors: Hideo
authors: H
authors: Baba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018395:CA-19-9 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D017024:Chemotherapy, Adjuvant / Q000009:adverse effects; D015179:Colorectal Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000188:drug therapy / Q000473:pathology / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D009944:Organoplatinum Compounds / Q000627:therapeutic use; D000077150:Oxaliplatin; D011379:Prognosis
chemical_list: D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen; D009944:Organoplatinum Compounds; D000077150:Oxaliplatin
keywords: Colorectal cancer; chemotherapy; colorectal liver metastasis; hepatectomy