Value of serum carbohydrate antigen 19-9 for predicting extrahepatic metastasis in patients with liver metastasis from colorectal carcinoma.

BACKGROUND/AIMS: Serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) are frequently elevated in patients with colorectal carcinoma. However, the predictive utility of these two markers has not been fully investigated in patients with liver metastasis.

METHODOLOGY

We retrospectively analyzed data obtained from 90 hepatectomy or non-hepatectomy patients with liver metastases from colorectal carcinoma. We examined correlation between serum levels of CEA and CA19-9 and other clinicopathologic factors and performed univariate and multivariate analyses to determine the impact of these tumor markers on extrahepatic metastasis after admission to our hospital.

RESULTS

CEA elevation correlated to advanced age (> or = 60 years), and CA19-9 elevation correlated with the site (colon) of primary tumor. Univariate analysis showed that treatment without hepatectomy, > or = 4 hepatic tumors, and CA19-9 elevation had been an adverse effect on extrahepatic disease-free survival time after admission. Multivariate analysis showed that CA19-9 elevation (risk ratio, 1.84) and treatment without hepatectomy (risk ratio, 1.62) had a significant effect on extrahepatic disease-free time.

CONCLUSIONS

In patients with colorectal liver metastasis, elevation of serum CA19-9 is a risk factor for extrahepatic metastasis, and CEA appears to be useless for predicting extrahepatic metastasis in these patients.