Positive Postoperative CEA is a Strong Predictor of Recurrence for Patients After Resection for Colorectal Liver Metastases

The role of carcinoembryonic antigen (CEA) in surveillance and follow-up of patients with colorectal cancer continues to be debated. The objective of this study was to assess the utility of postoperative CEA as a predictor of recurrence for patients with resected colorectal liver metastases (CLM). Patients were identified from a prospectively maintained CLM database, and were studied retrospectively. Patients with extrahepatic disease or initially unresectable CLM were excluded. All patients in this study received adjuvant systemic chemotherapy after resection. Between 1997 and 2007, a total of 318 consecutive patients were studied, with 168 patients (53 %) experiencing recurrence within 2 years. Various postoperative CEA cutoffs were tested as independent predictors of recurrence. A postoperative CEA a parts per thousand yen15 ng/ml obtained the highest hazard ratio (1.87; 95 % CI 1.09-3.2; p = 0.023) and was chosen to be included in the survival analysis in the multivariate model. A postoperative CEA a parts per thousand yen15 ng/ml had a specificity of 96 % and positive predictive value of 82 % for recurrence. On multivariate analysis, age a parts per thousand yen70 years, the presence of positive lymph node at primary tumor resection, disease-free interval a parts per thousand currency sign12 months, number of lesions > 1, largest lesion a parts per thousand yen5 cm, presence of positive margins, and postoperative CEA a parts per thousand yen15 ng/ml were independent predictors of recurrence within 2 years. This study demonstrates a postoperative CEA a parts per thousand yen15 ng/ml to be a predictive test for recurrence.