Are carcinoembryonic antigen levels of value in the curative management of colorectal cancer?

Although the carcinoembryonic antigen (CEA) is not specific for colorectal cancer, its strong correlation with many aspects of the disease has made it very useful in clinical management of this malignancy. There is controversy, however, about the real value of CEA determinations in the clinical decision-making process and about their impact on patient prognosis. This review analyzes the relative values of the preoperative CEA and postoperative serial CEA levels, the correlation with different patterns of recurrence, and the potential for detecting early recurrence and selecting patients for second-look surgery. Although there is potential for CEA-directed second-look surgery to retrieve patients through resection of early recurrence and possibly to increase the survival rate, the long-term effects on prognosis are yet to be determined.