Post-chemotherapeutic CEA and CA19-9 are prognostic factors in patients with colorectal liver metastases treated with hepatic resection after oxaliplatin-based chemotherapy

Anticancer Res. 2015 Apr;35(4):2359-68.

Abstract

Background/aim: The prognostic value of tumor markers remains unclear in patients with colorectal liver metastases (CRLM) who undergo hepatectomy following chemotherapy. The aim of the present study was to identify prognostic factors associated with recurrence and survival in such patients.

Patients and methods: Between 2005 and 2012, 62 patients with initially unresectable or marginally unresectable CRLM who underwent hepatectomy following chemotherapy were enrolled. A Cox proportional hazards model was used to identify the prognostic factors.

Results: Multivariate analysis indicated that a high level of carbohydrate antigen 19-9 (CA19-9) in serum post-chemotherapy was significant factor, predictive of poor overall survival [Hazard Ratio (HR)=4.46, 95% Confidence Interval (CI)=1.68-11.8; p=0.003] and marginally significant regarding poorer relapse-free survival (HR=2.11, 95% CI=0.99-4.47; p=0.050). Non-response to preoperative chemotherapy was a significant prognostic factor regarding shorter relapse-free (HR=2.18, 95% CI=1.10-4.33; p=0.026) and overall survival (HR=3.14, 95% CI=1.22-8.08; p=0.018). High levels of carcinoembryonic antigen CEA in serum post-chemotherapy (HR=3.08, 95% CI=1.13-8.39; p=0.028) and the absence of adjuvant chemotherapy (HR=2.27, 95% CI=1.17-4.41; p=0.016) were independent risk factors for recurrence.

Conclusion: Measurement of both CEA and CA19-9 level is strongly recommended for patients with CRLM treated with preoperative chemotherapy followed by hepatectomy because normalization of serum CEA and CA19-9 levels after chemotherapy will demonstrate a good prognosis after curative hepatectomy.

Keywords: Colorectal cancer; chemotherapy; colorectal liver metastasis; hepatectomy.

MeSH terms

  • Aged
  • Aged, 80 and over
  • CA-19-9 Antigen / blood*
  • Carcinoembryonic Antigen / blood*
  • Chemotherapy, Adjuvant / adverse effects
  • Colorectal Neoplasms / blood
  • Colorectal Neoplasms / drug therapy
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Disease-Free Survival
  • Female
  • Hepatectomy
  • Humans
  • Liver Neoplasms / blood
  • Liver Neoplasms / drug therapy
  • Liver Neoplasms / pathology
  • Liver Neoplasms / secondary
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / blood*
  • Neoplasm Recurrence, Local / drug therapy
  • Neoplasm Recurrence, Local / pathology
  • Neoplasm Recurrence, Local / surgery
  • Organoplatinum Compounds / therapeutic use
  • Oxaliplatin
  • Prognosis

Substances

  • CA-19-9 Antigen
  • Carcinoembryonic Antigen
  • Organoplatinum Compounds
  • Oxaliplatin