Clinical Significance of Serum Carcinoembryonic Antigen (CEA) Level at Diagnosis of Liver Metastases in Patients with Colorectal Cancer

Nam, Jung Su; Shin, Jin Yong; Kim, Kyoung Ha; Park, Jeong Ik; Kim, Woon Won; Choi, Chang Soo; Choi, Young Gil; Hong, Kwan Hee

Abstract

PURPOSE: In numerous clinical trials to stratify prognosis of patients with liver metastases (LM) from colorectal cancer (CRC), the clinical value of serum carcinoembryonic antigen (CEA) levels at diagnosis of LM has not been fully investigated in these group. The aim of this study is to explore the relation of CEA to characteristics of LM and to analyze prognostic value of this widely used tool.
METHODS
We retrospectively analyzed clinical data of 143 LM patients who were performed surgical intervention or non-surgical intervention. The cohort was divided into two groups; normal CEA group (NCEAG, <5 ng/ml, n=41) and elevated CEA group (ECEAG, > or =5 ng/ml, n=102). We examined correlation between serum CEA at diagnosis of LM and other clinicopathologic factors and performed univariate and multivariate analyses to determine the clinical impact of this marker on survival.
RESULTS
Compared to ECEAG, the characteristics of LM of NCEAG was associated with unilobar distribution of LM (P=0.003), less metastases (P<0.001), less rate of synchronocity (P=0.008) and more surgical intervention of hepatic deposits (P<0.001). The 5-year survival rate for NCEAG was better than ECEAG (P=0.031). Multivariate analysis revealed that the presence of lymphatic duct invasion, no performance of chemotherapy, bilobar distribution of LM, and treatment of non-surgical intervention had a significant effect on survival. CEA elevation was identified as independently associated with bilobar distribution and non-surgical intervention of LM.
CONCLUSIONS
Although CEA level is not a independent prognostic factor in this study, the clinical characteristics identified in this study and correlation to non surgical intervention of LM may help better patient selection in the management of CRC LM patients.