Serum CEA in the follow-up of colorectal carcinoma: experience in a district general hospital.

Serum CEA was measured at 6-monthly intervals, over a 3-year period, in 102 patients being followed up after apparently complete excision of colorectal carcinoma. Residual disease was identified in 27 patients and was preceded by a CEA rise in 22 of these patients (81.5%). The CEA was initially normal in 68% of patients with residual disease in whom it subsequently rose. Rise in CEA was not detected until a median of 14 weeks before recurrence was diagnosed clinically. CEA-instigated second-look laparotomy was performed in 7 patients (31.5% of cases with CEA-associated residual disease). Despite a high resectability rate, no patient was cured. The results might have been improved by more frequent CEA measurement and more immediate second-look laparotomy, but in this study, CEA rise was not associated with surgically curable residual disease.