Carcinoembryonic Antigen as a Prognostic Factor in Colorectal Cancer with Liver Metastases

George E Mcnally,Jorge P Grondona,David M Lloyd

doi:10.4236/jct.2015.612113

George E Mcnally, Jorge P Grondona + Show 1 more

Open Access

https://doi.org/10.4236/jct.2015.612113

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Abstract

Aim: The objective of this study was to investigate the prognostic value of serum carcinoembryonic antigen (CEA) level in colorectal cancer patients with liver metastases. The serum CEA level was recorded at the point of metastasis diagnosis, differing from the majority of literature looking at preoperative metastasectomy CEA level. Methods: From January 2010 to December 2014, 138 patients with a diagnosis of colorectal cancer and liver metastases were included in the study—population from Buenos Aires, Argentina. Patients with both resectable and unresectable liver metastases were followed up over a 4-year period. Kaplan Meier survival analysis was used to produce survival curves that were compared by log-rank test. Results: The overall survival for all patients studied with a CEA

Highlights

Colorectal carcinoma (CRC) is the commonest malignancy of the digestive tract and the third most common cancer in the Western world [1]
Raised serum carcinoembryonic antigen (CEA) levels (≥100 ng/mL) recorded at the point of metastasis diagnosis were observed in 42 patients (39.6%) and 64 patients (60.4%) had a low CEA level (
This study confirms that there is a significant difference in the survival of all patients with colorectal liver metastases when stratified for CEA levels (CEA < 100 or ≥100 ng/mL) taken at metastasis diagnosis

Summary

Introduction

Colorectal carcinoma (CRC) is the commonest malignancy of the digestive tract and the third most common cancer in the Western world [1]. The most important risk factor is the age with disease rarely developing in people under the age of 40. The majority of colorectal cancers develop sporadically, family history of CRC in a first-degree relative confers a 2- to 3-fold increased risk of disease. The liver is the most common site for colorectal cancer metastases due to the enteric venous drainage via the portal circulation with up to 50% of CRC patients developing liver metastases [2] [3]. Studies have shown that 10% - 30% of patients with liver-limited colorectal metastases have potentially resectable disease at the point of detection and can be treated surgically aiming for improving prognosis and potential long-term cure [5]. Recent advances in the surgical technique for partial hepatectomy, indications for liver resection, imaging modalities and perioperative care have increased the number of patients suitable for surgical resection and the overall safety of the procedure [6] [7]

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