Prognostic value of postoperative carcinoembryonic antigen concentration and extent of invasion of resection margins after hepatic resection for colorectal metastases.


Autoria(s): Gervaz P.; Blanchard A.; Pampallona S.; Mach J.P.; Fontolliet C.; Gillet M.
Data(s)

2000

Resumo

OBJECTIVE: To evaluate the prognostic value of postoperative concentration of carcinoembryonic antigen (CEA) and extent of surgical margins after resection of liver metastases from colorectal cancer. DESIGN: Retrospective study. SETTING: Teaching hospital, Switzerland. SUBJECTS: 49 patients with hepatic metastases after primary colorectal cancer. INTERVENTIONS: Resection of hepatic metastases MAIN OUTCOME MEASURES: Assessment of prognostic value of variables by univariate and multivariate analysis. RESULTS: Median survival was 24 months (range 5-86 months). Resection margins were clear (> 1-cm) in 10, close (< 1-cm) in 25 and invaded in 9 patients. On univariate analysis, a postoperative concentration of CEA of <4ng/ml was correlated with prolonged survival (p < 0.001), but the width of the resection margin was not of prognostic importance. There was no correlation between width of resection margins and postoperative concentration of CEA (p = 0.5). On multivariate analysis, postoperative concentrations of CEA of 4 ng/ml or more were associated with increased risk of death (relative risk 7.3; 95% confidence interval (CI) 2.8-18.7, p < 0.001). CONCLUSION: Postoperative CEA offers better prognostic discrimination than the width of resection margins after resection of liver metastases from colorectal tumours. Some patients with invaded resection margins did survive for 3 years, but no patient did whose CEA concentration was 4 ng/ml or more. The definition of a potentially curative hepatic resection should include a postoperative CEA concentration of <4 ng/ml (within the reference range).

Identificador

http://serval.unil.ch/?id=serval:BIB_16131

isbn:1102-4151 (Print)

pmid:10965835

doi:10.1080/110241500750008637

isiid:000088426200008

Idioma(s)

en

Fonte

European Journal of Surgery, vol. 166, no. 7, pp. 557-561

Palavras-Chave #Carcinoembryonic Antigen/blood; Colorectal Neoplasms/mortality; Colorectal Neoplasms/pathology; Female; Humans; Liver Neoplasms/blood; Liver Neoplasms/mortality; Male; Multivariate Analysis; Neoplasm Invasiveness; Postoperative Period; Predictive Value of Tests; Prognosis; Survival Analysis
Tipo

info:eu-repo/semantics/article

article