Serum carcinoembryonic antigen monitoring after curative resection for colorectal cancer: clinical significance of the preoperative level.

Abstract:

AIM:We evaluated preoperative serum carcinoembryonic antigen (CEA) as a prognostic factor for colorectal cancer and determined when surveillance of this marker was useful. METHODS:Serum CEA was measured preoperatively in 1,263 patients who underwent curative resection for colorectal cancer at 3-month intervals for the first 2 postoperative years and at 6-month intervals thereafter. Mean follow-up was 48 months (range 1-156 months). RESULTS:The 5-year disease-free survival was less in patients with a high preoperative serum CEA level (P<0.0001). Among patients with a tumor recurrence, 38.5% had high follow-up serum CEA levels. The number of patients with high postoperative serum CEA levels exceeded the number of patients with high preoperative levels. High preoperative and follow-up serum CEA levels were independent prognostic factors for tumor recurrence (P=0.003 and P<0.001, respectively). In patients with high preoperative serum CEA levels, CEA surveillance had a 92.3% positive predictive value (PPV) and a 96.1% negative predictive value (NPV). The mean interval between postoperative serum CEA elevation and the diagnosis of a tumor recurrence [diagnostic interval (DI)] was 2.5 months (range 5-17 months). The DI was 0 in 18.8% of patients with a tumor recurrence. CONCLUSION:High serum CEA levels preoperatively and at follow-up are prognostic factors for colorectal cancer. Postoperative serum CEA surveillance is used most effectively when patients have high preoperative serum CEA levels. Considering the DI of 0 in 18.8% of the patients, the current CEA surveillance schedule might be changed.

journal_name

Ann Surg Oncol

authors

Park IJ,Choi GS,Lim KH,Kang BM,Jun SH

doi

10.1245/s10434-009-0625-z

subject

Has Abstract

pub_date

2009-11-01 00:00:00

pages

3087-93

issue

11

eissn

1068-9265

issn

1534-4681

journal_volume

16

pub_type

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