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Monitoring carcinoembryonic antigen in colorectal cancer: Is it still useful?

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Abstract

The results of a study conducted to determine the usefulness of carcinoembryonic antigen (CEA) monitoring in the follow-up of patients with resected colorectal cancer are reported herein. The subjects of this study were 125 patients in whom CEA had been determined preoperatively and 239 patients in whom CEA had been monitored postoperatively. The results revealed increased preoperative CEA in only 24% of the subjects, and that this increment was correlated with subsequent more advanced tumor stage and a higher recurrence rate (P<0.01). The postoperative CEA level exceeded the threshold in 71% of the patients affected by recurrence, 94.4% of whom developed liver metastases and 50%, nonhepatic recurrence. This marker showed elevated sensitivity for liver metastases (99%), whereas the sensitivity was lower for nonhepatic recurrence of the disease (94%). Thus, we concluded that CEA monitoring can be useful for preoperative colorectal tumor grading, even if its validity in the early diagnosis of recurrence is problematic, especially in terms of radical repeated surgery and survival.

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References

  1. Moertel CG, Fleming TR, Macdonald JS, Haller DG, Laurie JA, Tangen C (1993) An evaluation of the carcinoembryonic antigen (CEA) test for monitoring patients with resected colon cancer. JAMA 270:943–947

    Article  CAS  PubMed  Google Scholar 

  2. Li Destri G, Craxi G, Rinzivillo C, Bonanno G, Di Cataldo A, Puleo S, Licata A, Rodolico G (1996) Il follow-up colorettale. Nostra esperienza. Chirurgia 9:261–267

    Google Scholar 

  3. Li Destri G, Rinzivillo C, Craxi G, Naso P, La Greca G, Di Cataldo A, Puleo S, Licata A (1998) Colorectal follow-up planning modified on the basis of our personal experience. Dig Surg 15:64–68

    Article  Google Scholar 

  4. Fantini GA, DeCosse JJ (1990) Surveillance strategies after resection of carcinoma of the colon and rectum. Surg Gynecol Obstet 171:267–273

    CAS  PubMed  Google Scholar 

  5. Fletcher RH (1993) CEA monotoring after surgery for colorectal cancer. When is the evidence sufficient? JAMA 270:987–988

    Article  CAS  PubMed  Google Scholar 

  6. Schneebaum S, Arnold MW, Young D, LaValle GJ, Petty L, Berens A, Mojzisik C, Martin EW Jr (1993) Role of carcinoembryonic antigen in prediciting resectability of recurrent colorectal cancer. Dis Colon Rectum 36:810–815

    Article  CAS  PubMed  Google Scholar 

  7. Bohm B, Schcwenk W, Hucke HP, Stock W (1993) Does methodic long-term follow-up affect survival after curative resection of colorectal carcinoma? Dis Colon Rectum 36:280–286

    Article  CAS  PubMed  Google Scholar 

  8. Wang JY, Tang R, Chiang JM (1994) Value of carcinoembryonic antigen in the management of colorectal cancer. Dis Colon Rectum 37:272–277

    Article  CAS  PubMed  Google Scholar 

  9. Chu DZ, Erickson CA, Russell MP (1991) Prognostic significance of carcinoembryonic antigen in colorectal carcinoma. Arch Surg 126:314–316

    CAS  PubMed  Google Scholar 

  10. Slentz K, Senagore A, Hibbert J, Mazier WP, Talbott TM (1994) Can preoperative and postoperative CEA predict survival after colon cancer resection? Am Surg 60:528–532

    CAS  PubMed  Google Scholar 

  11. Kimura O, Kaibara N, Nishidoi H, Okamoto T, Takebayashi M, Kawasumi H, Koga S (1986) Carcinoembryonic antigen slope analysis as an early indicator for recurrence of colorectal carcinoma. Jpn J Surg 16:106–111

    Article  CAS  PubMed  Google Scholar 

  12. Takeda S, Hisaomi K, Nakano S, Ohamoto K, Nagafuchi Y, Hoh H, Ohsato K (1995) A 10-year survivor with unresectable hepatic metastases from sigmoid colon carcinoma treated with regional chemotherapy. Surg Today 25:440–443

    Article  CAS  PubMed  Google Scholar 

  13. Vernava AM, Longo WE, Virgo KS, Coplin MA, Wade TP, Johnson FE (1994) Current follow-up strategies after resection of colon cancer. Dis Colon Rectum 37:573–583

    Article  PubMed  Google Scholar 

  14. Bruinvels DJ, Stiggelbout AM, Kievit J, van Houwelingen HC, Habbema DF, van de Velde CJ (1994) Follow-up of patients with colorectal cancer. A meta-analysis. Ann Surg 219:174–182

    Article  CAS  PubMed  Google Scholar 

  15. Zeng Z, Cohen AM, Urmacher C (1993) Usefulness of carcinoembryonic antigen monitoring despite normal preoperative values in node-positive colon cancer patients. Dis Colon Rectum 36:1063–1068

    Article  CAS  PubMed  Google Scholar 

  16. Rocklin MS, Slomski CA, Watne AL (1990) Postoperative surveillance of patients with carcinoma of the colon and rectum. Am Surgeon 56:22–27

    CAS  PubMed  Google Scholar 

  17. Schiessel R, Wunderlich M, Herbst F (1986) Local recurrence of colorectal cancer: effect of early detection and aggressive surgery. Br J Surg 73:342–344

    Article  CAS  PubMed  Google Scholar 

  18. Barillari P, Bolognese A, Chirletti P, Cardi M, Sammartino P, Stipa V (1992) Role of CEA, TPA and Ca 19-9 in the early detection of localized and diffuse recurrent rectal cancer. Dis Colon Rectum 35:471–476

    Article  CAS  PubMed  Google Scholar 

  19. McCall JL, Black RB, Rich CA, Harvey JR, Baker RA, Watts JM, Toouli J (1994) The value of serum carcinoembryonic antigen in predicting recurrent disease following curative resection of colorectal cancer. Dis Colon Rectum 37:875–881

    Article  CAS  PubMed  Google Scholar 

  20. Ohlsson B, Breland U, Ekberg H, Graffner H, Tranberg KG (1995) Follow-up after curative surgery for colorectal carcinoma. Dis Colon Rectum 38:619–626

    Article  CAS  PubMed  Google Scholar 

  21. Camunas J, Enriquez JM, Devesa JM, Morales V, Millan I (1991) Value of follow-up in the management of recurrent colorectal cancer. Eur J Surg Oncol 17:530–535

    CAS  PubMed  Google Scholar 

  22. Northover JM (1985) Carcinoembryonic antigen and recurrent colorectal cancer. Br J Surg 72:544–545

    Article  Google Scholar 

  23. Adloff M, Arnaud JP, Ollier JC, Schloegel M (1989) Peut-on améliorer le pronostic des malades opérés d'un cancer du colon ou du rectum par une surveillance régulière? Chirurgie 115:228–237

    CAS  PubMed  Google Scholar 

  24. Sugarbaker PH, Gianola FJ, Dwyer A, Neuman NR (1987) A simplified plan for follow-up of patients with colon and rectal cancer supported by prospective studies of laboratory and radiologic test results. Surgery 102:79–87

    CAS  PubMed  Google Scholar 

  25. Wanebo HJ, Llaneras M, Martin T, Kaiser D (1989) Prospective monitoring trial for carcinoma of colon and rectum after surgical resection. Surg Gynecol Obstet 169:479–487

    CAS  PubMed  Google Scholar 

  26. Steele G, Bladey R, Mayer R, Lindblad A (1991) A prospective evaluation of hepatic resection for colorectal carcinoma metastases to the liver: Gastrointestinal Tumor Study Group protocol 6584. J Clin Oncol 9:1105–1112

    PubMed  Google Scholar 

  27. Sardi A, Nieroda CA, Siddiqi MA, Minton JP, Martin EW (1990) Carcinoembryonic antigen directed multiple surgical procedures for recurrent colon cancer confined to the liver. Am Surgeon 56:255–259

    CAS  PubMed  Google Scholar 

  28. Hohenberger P, Schlag PM, Gerneth T, Herfarth C (1994) Pre- and postoperative carcinoembryonic antigen determinations in hepatic resection for colorectal metastases. Ann Surg 216:135–143

    Article  Google Scholar 

  29. Ohlsson B, Tranberg KG, Lundstedt C, Ekberg H, Hederstrom E (1993) Detection of hepatic metastases in colorectal cancer: a prospective study of laboratory and imaging methods. Eur J Surg 159:275–281

    CAS  PubMed  Google Scholar 

  30. Hine KR, Dykes PW (1984) Serum CEA testing in the postoperative surveillance of colorectal carcinoma. Br J Cancer 49:689–693

    CAS  PubMed  Google Scholar 

  31. Roberts PJ (1988) Tumour markers in colorectal cancer. Scand J Gastroenterol Suppl 23:50

    Article  Google Scholar 

  32. Kievit J, van de Velde CJ (1990) Utility and cost of carcinoembryonic antigen monitoring in colon cancer follow-up: a Markov analysis. Cancer 65:2580–2587

    Article  CAS  PubMed  Google Scholar 

  33. Makela JT, Laitinen SO, Kairaluoma MI (1995) Five-year follow-up after radical surgery for colorectal cancer. Arch Surg 130:1062–1067

    CAS  PubMed  Google Scholar 

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Authors and Affiliations

  1. First Surgical Clinic, University of Catania, Policlinico, via Santa Sofia, Catania, Italy

    Giovanni Li Destri, Salvatore Greco, Calogero Rinzivillo & Agostino Racalbuto

  2. Second Pediatric Clinic, University of Catania, Policlinico, via Santa Sofia, Catania, Italy

    Roberto Curreri & Antonio Di Cataldo

Authors
  1. Giovanni Li Destri
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  2. Salvatore Greco
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  3. Calogero Rinzivillo
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  4. Agostino Racalbuto
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  5. Roberto Curreri
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  6. Antonio Di Cataldo
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Li Destri, G., Greco, S., Rinzivillo, C. et al. Monitoring carcinoembryonic antigen in colorectal cancer: Is it still useful?. Surg Today 28, 1233–1236 (1998). https://doi.org/10.1007/BF02482805

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  • DOI: https://doi.org/10.1007/BF02482805

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