BACKGROUND: Carcinoembryonic antigen (CEA) as a marker in the follow-up after curative resection of colorectal carcinoma (CRC) is often omitted from follow-up despite guideline recommendations. One reason is the assumption that when a normal CEA value exists before curative resection of CRC, it will neither rise during follow-up. This study investigates this relationship. METHOD: Data were derived from a study initiated to evaluate treatment regimes for rectal carcinoma (Dutch TME trial, n=1861) from which 954 were eligible for analysis. Recurrent disease occurred in 272 of these patients (29.5%). The pre-operative CEA value was compared to CEA values during follow-up, using threshold values of 2.5 and 5.0 ng/ml. RESULTS: Normal pre-operative CEA values were present in 63% (CEA<5.0) and 39% (CEA<2.5) of patients with recurrent disease. Patients with a normal pre-operative CEA and recurrent disease had elevated CEA values during follow-up in 41% (CEA<5.0), 50% (CEA<2.5) and in 60% with both threshold values when the last measurement was done within 3 months before recurrent disease was diagnosed. CONCLUSION: A normal pre-operative CEA is common in patients with rectal carcinoma. CEA does rise due to recurrent disease in at least 50% of patients with normal pre-operative values. Serial post-operative CEA testing cannot be discarded based on a normal pre-operative serum CEA.
BACKGROUND:Carcinoembryonic antigen (CEA) as a marker in the follow-up after curative resection of colorectal carcinoma (CRC) is often omitted from follow-up despite guideline recommendations. One reason is the assumption that when a normal CEA value exists before curative resection of CRC, it will neither rise during follow-up. This study investigates this relationship. METHOD: Data were derived from a study initiated to evaluate treatment regimes for rectal carcinoma (Dutch TME trial, n=1861) from which 954 were eligible for analysis. Recurrent disease occurred in 272 of these patients (29.5%). The pre-operative CEA value was compared to CEA values during follow-up, using threshold values of 2.5 and 5.0 ng/ml. RESULTS: Normal pre-operative CEA values were present in 63% (CEA<5.0) and 39% (CEA<2.5) of patients with recurrent disease. Patients with a normal pre-operative CEA and recurrent disease had elevated CEA values during follow-up in 41% (CEA<5.0), 50% (CEA<2.5) and in 60% with both threshold values when the last measurement was done within 3 months before recurrent disease was diagnosed. CONCLUSION: A normal pre-operative CEA is common in patients with rectal carcinoma. CEA does rise due to recurrent disease in at least 50% of patients with normal pre-operative values. Serial post-operative CEA testing cannot be discarded based on a normal pre-operative serum CEA.
Authors: Thijs Wieldraaijer; Pascal Bruin; Laura A M Duineveld; Pieter J Tanis; Anke B Smits; Henk C P M van Weert; Jan Wind Journal: Dig Surg Date: 2017-03-14 Impact factor: 2.588
Authors: I Tarantino; R Warschkow; M Worni; K Merati-Kashani; D Köberle; B M Schmied; S A Müller; T Steffen; T Cerny; U Güller Journal: Br J Cancer Date: 2012-06-26 Impact factor: 7.640
Authors: Won Kyung Cho; Doo Ho Choi; Hee Chul Park; Won Park; Jeong Il Yu; Young Suk Park; Joon Oh Park; Ho Yeong Lim; Won Ki Kang; Hee Cheol Kim; Yong Beom Cho; Seong Hyeon Yun; Woo Yong Lee Journal: Oncotarget Date: 2017-11-18
Authors: Floris T J Ferenschild; Imro Dawson; Johannes H W de Wilt; Eelco J R de Graaf; Richard P R Groenendijk; Geert W M Tetteroo Journal: Int J Colorectal Dis Date: 2009-06-02 Impact factor: 2.571
Authors: Brian D Nicholson; Bethany Shinkins; Indika Pathiraja; Nia W Roberts; Tim J James; Susan Mallett; Rafael Perera; John N Primrose; David Mant Journal: Cochrane Database Syst Rev Date: 2015-12-10