Meta-Analysis
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Dec 27, 2023; 15(12): 2890-2906
Published online Dec 27, 2023. doi: 10.4240/wjgs.v15.i12.2890
Prognostic role of serum carcinoembryonic antigen in patients receiving liver resection for colorectal cancer liver metastasis: A meta-analysis
Fan Tang, Cheng-Wen Huang, Zhi-Hong Tang, Shao-Long Lu, Tao Bai, Qing Huang, Xing-Zhi Li, Bin Zhang, Fei-Xiang Wu
Fan Tang, Cheng-Wen Huang, Zhi-Hong Tang, Shao-Long Lu, Tao Bai, Qing Huang, Xing-Zhi Li, Bin Zhang, Fei-Xiang Wu, Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Fei-Xiang Wu, Key Laboratory of High-Incidence-Tumor Prevention & Treatment, Ministry of Education, Nanning 530021, Guangxi Zhuang Autonomous Region, China
Author contributions: Tang F and Huang CW contributed equally to this work. Tang F, Huang CW, and Wu FX contributed to the conceptualization of this study; Tang F, Huang CW, Li XZ, and Zhang B involved in the methodology and formal analysis of this article; Tang F and Huang CW participated in the investigation of this research; Bai T, Huang Q, and Wu FX took part in the validation of this manuscript; Tang ZH and Wu FX involved in the software of this study; Tang F and Huang CW participated in the writing - original draft preparation of this article; all authors contributed to the writing - review and editing of this manuscript; Tang ZH and Lu SL took part in the resources and data curation of this study; Wu FX contributed to the supervision of this article; and all authors read and approved the final manuscript.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Fei-Xiang Wu, DSc, Doctor, Professor, Researcher, Surgeon, Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, No. 71 Hedi Road, Nanning 530021, Guangxi Zhuang Autonomous Region, China. wufeixiang@gxmu.edu.cn
Received: August 2, 2023
Peer-review started: August 2, 2023
First decision: October 20, 2023
Revised: November 3, 2023
Accepted: November 28, 2023
Article in press: November 28, 2023
Published online: December 27, 2023
Processing time: 147 Days and 10.5 Hours
Abstract
BACKGROUND

Carcinoembryonic antigen (CEA) is a broad-spectrum tumor marker for differential diagnosis, monitoring, and response assessment of a variety of malignancies.

AIM

To evaluate whether serum CEA could predict the prognosis in patients with colorectal cancer liver metastasis (CRCLM) before and after liver resection (LR).

METHODS

PubMed, Embase, Cochrane, and Web of Science were systematically searched to retrieve literature, with a search cut-off date of February 27, 2023. Articles were strictly screened for inclusion according to pre-specified inclusion and exclusion criteria. Data were pooled and analyzed using Stata 16.0.

RESULTS

This meta-analysis included 36 studies involving a total of 11143 CRCLM patients. The results showed that a high pre-LR serum CEA level was correlated with poor overall survival (OS) [hazard ratio (HR) = 1.61, 95% confidence interval (CI): 1.49-1.75, P < 0.001] and recurrence-free survival (HR = 1.27, 95%CI: 1.11-1.45, P < 0.001) in CRCLM patients. A high post-LR serum CEA level predicted poor OS (HR = 2.66, 95%CI: 2.10-3.38, P < 0.001). A comparison by treatment modality, analysis modality, patient source, and cutoff-value showed that overall, high preoperative and postoperative serum CEA levels remained correlated with a poor prognosis.

CONCLUSION

This study concluded that high pre-LR and post-LR serum CEA levels were significantly correlated with a poor prognosis in CRCLM patients.

Keywords: Carcinoembryonic antigen; Colorectal cancer liver metastasis; Liver resection; Meta-analysis

Core Tip: Carcinoembryonic antigen (CEA) is a broad-spectrum tumor marker for differential diagnosis, monitoring, and response assessment of a variety of malignancies. This meta-analysis was aimed at evaluating whether serum CEA could predict the prognosis in patients with colorectal cancer liver metastasis before and after liver resection. Articles were strictly screened for inclusion according to pre-specified inclusion and exclusion criteria.