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The relationship between prognosis and CEA-dt after hepatic resection in patients with colorectal carcinomas
1Department of Surgery, National Cancer Center Hospital, 1-1 Tsukiji 5-chome, Chuo-ku, Tokyo 104, Japan.
Aims:
CEA-doubling time (CEA-dt) was calculated by measuring serum CEA at two voluntary points. As CEA-dt is correlated with tumour doubling time the growth rate of liver metastasis could be determined. We investigated the relationship between CEA-dt and prognosis to determine the indications for resection of liver metastasis.
Methods:
We examined 334 patients diagnosed with resected liver metastasis of colorectal carcinoma. Patients were divided into three categories based on CEA-dt; Group A, CEA-dt <30 days; Group B, 30 days /=s80 days. Clinicopathological parameters, the 3-year or 5-year survival rate and the rate of recurrence were compared among the three groups.
Results:
In Group A, the survival time after hepatic resection was significantly shorter compared to the other groups. Furthermore, multiple liver metastasis showed slightly reduced CEA-dt levels compared with solitary metastasis, but even in patients with solitary liver metastasis, the rate of survival was poor. In 70% of Group A patients, recurrent tumour was recognized within 1 year of hepatic resection.
Conclusion:
When surgery for liver metastasis of colorectal cancer is considered. Group A patients should be recognized as having a poor prognosis and a high rate of recurrence after hepatic resection, and CEA-dt should be employed as a prognostic factor.