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Clinical Usefulness of Postoperative Serum Carcinoembryonic Antigen in Patients with Colorectal Cancer with Liver Metastases

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Colorectal cancer with liver metastasis (CLM) has high postoperative recurrence rates; therefore, optimizing perioperative treatment is imperative. Postoperative carcinoembryonic antigen (CEA) can aid in detecting minimal residual disease in colon cancer following curative resection. This study aimed to identify the potential role of serum CEA following liver resection in patients with CLM.

Methods

This retrospective study was conducted at the Cancer Institute Hospital of the Japanese Foundation for Cancer Research from 2004 to 2018 and enrolled patients with CLM who underwent complete resection of primary tumors and CLM. Associations between perioperative CEA levels and characteristics of recurrence were investigated.

Results

Recurrence was detected during a median follow-up period of 90.1 months in 343 (54.2%) out of 633 analyzed patients. Patients in the postoperative CEA level > 5 ng/ml group had a significantly higher recurrence rate (75.7% versus 50.0%, p < 0.01) and shorter time until recurrence (4.4 versus 36.9 months, p < 0.01) than those in the postoperative CEA level ≤ 5 ng/ml group. Multivariate analysis revealed that postoperative CEA level > 5 ng/ml was an independent predictor, with hazard ratios of 2.77 (p < 0.01) for recurrence-free survival (RFS) and 3.18 (p < 0.01) for overall survival (OS). Additionally, RFS was significantly shorter among patients in the postoperative CEA level > 5 ng/ml group who did not have normalized CEA levels following adjuvant chemotherapy than among those in the normalized CEA group.

Conclusions

The postoperative and post-adjuvant chemotherapy CEA levels in the CEA level > 5 ng/ml group may be predictors of RFS and OS.

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Acknowledgment

The authors thank Ms. Hitomi Hannan, Ms. Yukie Naito, and Ms. Yuki Horiike for data management.

Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Author notes

  1. Koichiro Yoshino and Hiroki Osumi have equally contributed to this work.

Authors and Affiliations

  1. Department of Gastroenterological Chemotherapy, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan

    Koichiro Yoshino MD, Hiroki Osumi MD, PhD, Daisaku Kamiimabeppu MD, Akira Ooki MD, PhD, Takeru Wakatsuki MD, PhD, Keitaro Shimozaki MD, Izuma Nakayama MD, PhD, Mariko Ogura MD, Daisuke Takahari MD, PhD, Keisho Chin MD, Kensei Yamaguchi MD & Eiji Shinozaki MD, PhD

  2. Division of Hepato-Biliary-Pancreatic Surgery, Cancer Institute Hospital of the Japanese Foundation for Cancer Research, Tokyo, Japan

    Hiromichi Ito MD, PhD, Atsushi Oba MD, PhD, Yoshihiro Ono MD, PhD, Takafumi Sato MD, PhD, Yosuke Inoue MD, PhD & Yu Takahashi MD, PhD

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Contributions

Conception and design: K.Y., H.O., E.S., H.I., and K.Y.; acquisition of data: K.Y., H.O., I.H.; analysis and interpretation of data: K.Y., H.O., E.S.; writing, review, and/or revision of the manuscript: all authors; administrative, technical, or material support: K.Y., H.O., E.S.; study supervision: K.Y.

Corresponding author

Correspondence to Eiji Shinozaki MD, PhD.

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Disclosures

Keisho Chin—Taiho Pharma, Ono Pharmaceutical Co., Ltd., Bristol–Myers Squibb, Chugai Pharmaceutical Co., Ltd., Merck & Co., Inc. Kensei Yamaguchi—relevant financial activities outside the submitted work: Taiho Pharm, Yakurt Honsha, Ono Pharmaceutical Co., Ltd.

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Yoshino, K., Osumi, H., Ito, H. et al. Clinical Usefulness of Postoperative Serum Carcinoembryonic Antigen in Patients with Colorectal Cancer with Liver Metastases. Ann Surg Oncol 29, 8385–8393 (2022). https://doi.org/10.1245/s10434-022-12301-w

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