title: Importance of the Postoperative Carcinoembryonic Antigen Level during Follow-Up after Curative Resection in Patients with Liver Metastatic Colorectal Carcinoma.
abstract: OBJECTIVE
  To validate the conventional Japanese grading of liver metastasis for no residual tumor resection in Stage IV colorectal cancer (CRC) with liver metastasis and to identify risk factors for postoperative recurrence.
  
  
  METHODS
  The subjects of this study were 1792 Stage IV CRC patients with liver metastasis.
  
  
  RESULTS
  In 1792 cases, including unresectable cases, there was a significantly different prognosis by grade (P < 0.0001). In 421 R0 cases, there was no significant difference between Grade A and Grade B (P = 0.8527). In 381 cases without extra-hepatic metastasis, the prognosis was not significantly different among three grades. On multivariate analysis, carcinoembryonic antigen within 3 months from R0 operation (3M-CEA) was an independent risk factor regardless of extrahepatic metastasis. There was a significantly different prognosis (P < 0.0001) among Grade A', defined as a normal 3M-CEA level, Grade B', defined as Grade A or B and an abnormal 3M-CEA level, and Grade C', defined as Grade C and an abnormal 3M-CEA level.
  
  
  CONCLUSIONS
  The postoperative CEA level is an important risk factor during follow-up after curative resection in patients with liver metastatic colorectal carcinoma. The combination of the 3M-CEA level and conventional grading of liver metastasis is useful for follow-up of R0 resection cases.
authors.forename: Takuzo
authors.initials: T
authors.lastname: Hashimoto
authors.forename: Michio
authors.initials: M
authors.lastname: Itabashi
authors.forename: Shinpei
authors.initials: S
authors.lastname: Ogawa
authors.forename: Tomoichiro
authors.initials: T
authors.lastname: Hirosawa
authors.forename: Yoshiko
authors.initials: Y
authors.lastname: Bamba
authors.forename: Sanae
authors.initials: S
authors.lastname: Kaji
authors.forename: Mamiko
authors.initials: M
authors.lastname: Ubukata
authors.forename: Satoru
authors.initials: S
authors.lastname: Shimizu
authors.forename: Kenichi
authors.initials: K
authors.lastname: Sugihara
authors.forename: Shingo
authors.initials: S
authors.lastname: Kameoka
mesh_terms: D002272:Carcinoembryonic Antigen / Q000097:blood*; D016009:Chi-Square Distribution; D015179:Colorectal Neoplasms / Q000401:mortality / Q000473:pathology*; D018450:Disease Progression; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D015203:Reproducibility of Results; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D002272:Carcinoembryonic Antigen