Jianwei Liu1,2, Yong Xia1, Lehua Shi1, Xifeng Li1, Lu Wu1, Zhenlin Yan3. 1. Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, 200438, China. 2. The First Clinical Medical College, Fujian Medical University, Fuzhou, Fujian, China. 3. Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, 200438, China. zhenlinyan@sohu.com.
Abstract
BACKGROUND: The relationship between serum carcinoembryonic antigen (CEA) and postoperative prognosis in hepatocellular carcinoma (HCC) has not been reported. METHODS: Data of 5410 consecutive HCC patients who underwent hepatectomy was retrospectively reviewed. Survival curves for overall survival (OS) and tumor recurrence (TR) were depicted using the Kaplan-Meier method and compared using the log-rank test. Independent risk factors of OS and TR were analyzed with Cox hazard regression model. Besides, a one-to-one propensity score-matched (PSM) subset was performed to reduce selection bias. Subgroup analysis was done according to hepatitis B virus (HBV) infection or not. RESULTS: Serum CEA ≥5.1 μg/L was an independent risk factor of OS and TR in the entire cohort and PSM subset (OS-hazard ratio = 1.218, 95 % confidence interval = 1.060-1.400; 1.383, 1.133-1.688, respectively; TR-1.256, 1.114-1.417; 1.258, 1.067-1.484, respectively). Subgroup analysis showed that CEA ≥5.1 μg/L was an independent risk factor of OS and TR in the HBV infection group (OS-1.234, 1.065-1.429; TR-1.231, 1.083-1.399) but not in the non-HBV infection group (OS-1.376, 0.895-2.117; TR-1.437, 0.989-2.088). CONCLUSION: Serum CEA ≥5.1 μg/L was an independent risk factor of OS and TR of HCC patients, and patients with CEA ≥5.1 μg/L had poorer prognosis, especially for HCC patients with HBV infection.
BACKGROUND: The relationship between serum carcinoembryonic antigen (CEA) and postoperative prognosis in hepatocellular carcinoma (HCC) has not been reported. METHODS: Data of 5410 consecutive HCCpatients who underwent hepatectomy was retrospectively reviewed. Survival curves for overall survival (OS) and tumor recurrence (TR) were depicted using the Kaplan-Meier method and compared using the log-rank test. Independent risk factors of OS and TR were analyzed with Cox hazard regression model. Besides, a one-to-one propensity score-matched (PSM) subset was performed to reduce selection bias. Subgroup analysis was done according to hepatitis B virus (HBV) infection or not. RESULTS: Serum CEA ≥5.1 μg/L was an independent risk factor of OS and TR in the entire cohort and PSM subset (OS-hazard ratio = 1.218, 95 % confidence interval = 1.060-1.400; 1.383, 1.133-1.688, respectively; TR-1.256, 1.114-1.417; 1.258, 1.067-1.484, respectively). Subgroup analysis showed that CEA ≥5.1 μg/L was an independent risk factor of OS and TR in the HBV infection group (OS-1.234, 1.065-1.429; TR-1.231, 1.083-1.399) but not in the non-HBV infection group (OS-1.376, 0.895-2.117; TR-1.437, 0.989-2.088). CONCLUSION: Serum CEA ≥5.1 μg/L was an independent risk factor of OS and TR of HCCpatients, and patients with CEA ≥5.1 μg/L had poorer prognosis, especially for HCCpatients with HBV infection.
Authors: Shimul A Shah; Sean P Cleary; Alice C Wei; Ilun Yang; Bryce R Taylor; Alan W Hemming; Bernard Langer; David R Grant; Paul D Greig; Steven Gallinger Journal: Surgery Date: 2006-11-01 Impact factor: 3.982