Of 340 patients with histologically proven colorectal carcinoma, hepatic metastases were diagnosed in 90 (26 per cent), in 50 at the time of initial surgery (synchronously) and in 40 during the post-operative follow-up (metachronously). At the time of initial surgery, plasma carcinoembryonic antigen (CEA) levels were markedly elevated in patients with synchronous metastases and normal or only moderately elevated in those with metachronous metastases. During follow-up, CEA levels in the entire group of patients with metastases remained normal in 8 per cent and rose in the remainder: very quickly in 85 per cent and slowly in 15 per cent.
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