title: Evaluation of carcinoembryonic antigen (CEA) density as a prognostic factor for percutaneous ablation of pulmonary colorectal metastases.
abstract: OBJECTIVE
  To evaluate the prognostic value of carcinoembryonic antigen (CEA) density and other clinicopathological factors for percutaneous ablation of pulmonary metastases from colorectal cancer.
  
  
  METHODS
  CEA density was calculated as: "absolute serum CEA pre-ablation/volume of all lung metastases [mm3]". Median CEA density was the cut-off for high and low groups. Cox-regression was used to determine prognostic factors for survival.
  
  
  RESULTS
  A total of 85 patients (102 ablation sessions) were followed for a median of 27 months. High CEA density was significantly associated with worse overall survival compared to low CEA density (adjusted HR: 2.12; 95 % CI: 1.22-3.70, p=0.002; median survival: 25.7 vs. 44.3 months). The interval between primary resection of the colorectal carcinoma and first ablation was also a prognostic factor, a duration >24 months being associated with better survival compared to a shorter interval (0-24 months) (adjusted HR: 0.55; 95 % CI: 0.31-0.98, p=0.04). Moreover, a disease-free interval >24 months was significantly associated with low CEA density compared to a shorter interval (0-24 months) (adjusted OR: 0.29; 95 % CI: 0.11-0.77, p=0.01).
  
  
  CONCLUSIONS
  Serum CEA density and interval between primary resection of a colorectal carcinoma and pulmonary ablation are independent prognostic factors for overall survival. In two patients with identical CEA serum levels, the patient with the lower/smaller pulmonary tumour load would have a worse prognosis than the one with the higher/larger pulmonary metastases.
  
  
  CONCLUSIONS
  • CEA density is an independent prognostic factor for colorectal pulmonary metastases. • A lower CEA density is associated with better overall survival. • CEA may play a functional role in tumour progression. • High CEA density is associated with smaller tumours. • Interval between pulmonary ablation and primary colorectal carcinoma is a prognostic factor.
authors.affiliation: Hepatobiliary and Surgical Oncology Unit, UNSW Department of Surgery, St George Hospital, Level 3, Pitney Building, Kogarah, NSW, 2217, Australia.|St George Hospital Clinical School, UNSW Australia, Kensington, NSW, Australia.
authors.forename: Ya Ruth
authors.initials: YR
authors.lastname: Huo
authors.affiliation: St George Hospital Clinical School, UNSW Australia, Kensington, NSW, Australia.|Department of Radiology, St George Hospital, Kogarah, NSW, Australia.
authors.forename: Derek
authors.initials: D
authors.lastname: Glenn
authors.affiliation: St George Hospital Clinical School, UNSW Australia, Kensington, NSW, Australia.|Cancer Care Centre, St George Hospital, Kogarah, NSW, Australia.
authors.forename: Winston
authors.initials: W
authors.lastname: Liauw
authors.affiliation: Department of Radiology, St George Hospital, Kogarah, NSW, Australia.
authors.forename: Mark
authors.initials: M
authors.lastname: Power
authors.affiliation: Hepatobiliary and Surgical Oncology Unit, UNSW Department of Surgery, St George Hospital, Level 3, Pitney Building, Kogarah, NSW, 2217, Australia.
authors.forename: Jing
authors.initials: J
authors.lastname: Zhao
authors.affiliation: Hepatobiliary and Surgical Oncology Unit, UNSW Department of Surgery, St George Hospital, Level 3, Pitney Building, Kogarah, NSW, 2217, Australia. David.Morris@unsw.edu.au.|St George Hospital Clinical School, UNSW Australia, Kensington, NSW, Australia. David.Morris@unsw.edu.au.
authors.forename: David L
authors.initials: DL
authors.lastname: Morris
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood*; D015179:Colorectal Neoplasms / Q000097:blood* / Q000401:mortality / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood* / Q000401:mortality / Q000556:secondary; D008297:Male; D008875:Middle Aged; D009517:New South Wales / Q000453:epidemiology; D011379:Prognosis; D015996:Survival Rate / Q000639:trends; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D002272:Carcinoembryonic Antigen
keywords: Carcinoembryonic antigen; Percutaneous ablation; Prognostic factor; Pulmonary colorectal metastases; Survival