Follow-up of patients operated on for colorectal carcinoma

Ovaska, Jari; Järvinen, Heikki; Kujari, Harry; Perttilä, Ilkka; Mecklin∥, Jukka–Pekka

doi:10.1016/s0002-9610(06)80074-7

Cited by 95 publications

(46 citation statements)

References 14 publications

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“…The (Moertel et al, 1978;Ovaska et al, 1990) have found it less sensitive and therefore unsatisfactory whereas Staab et al (1985) found it quite reliable. The present study, however, suggests that CEA may be of little practical value in local/distant metastases.…”

Section: Discussionmentioning

confidence: 98%

Comparison of plasma prolactin and CEA in monitoring patients with adenocarcinoma of colon and rectum

Patel²,

Giri³

et al. 1992

Br J Cancer

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Summary Plasma prolactin (PRL) and carcinoembryonic antigen (CEA) were measured by radioimmunoassay in 74 patients with adenocarcinoma of colon and rectum. The markers were correlated with disease stage, histological grade and progression/remission of disease. The circulating preoperative median PRL and CEA levels were significantly higher in colorectal cancer patients than in their respective controls. PRL was elevated in all Dukes stages and in all histological grades of the tumour whereas the rise in CEA was more pronounced in Dukes D. Out of 74 patients, 29% (21/74) developed recurrent disease and 31% (23/74) responded to the treatment. With regard to monitoring recurrence(s), the predictive value of PRL was 94% which was significantly greater than that of CEA which was only 62%. In patients who developed liver metastases PRL remained elevated whereas CEA showed more than 100-fold increase. Therefore, we feel that CEA is a better marker for monitoring patients who developed liver metastases. From our results, we suggest that PRL can be used as a better overall marker for detecting recurrence(s) in patients with colorectal adenocarcinoma.Recently, we have published data on circulating prolactin levels in patients with breast cancer (80% of these had advanced disease i.e. with stage III and IV). The data mainly concern relationship between circulating prolactin and histologic grade, estrogen-and progesterone-receptor (ER, PR) and 2 years postoperative survival (Bhatavdekar et al., 1990a). We have also found plasma prolactin useful both as an indicator of disease progression and as short-term prognosticator in patients with advanced breast cancer (Bhatavdekar et al., 1990b;1992). In light of the interesting and convincing results obtained by us in breast cancer patients, we have now tested the significance of prolactin in colorectal cancer, another common cancer in this region, by comparing simultaneously prolactin results with those of CEA.In this study therefore, we have compared the sensitivity and specificity of prolactin and CEA and thus the relative usefulness of these markers in monitoring recurrences in patients with colorectal adenocarcinomas. In addition, plasma prolactin and CEA levels were also correlated with disease stage and histologic grade. Plasma PRL and CEA were assayed using double antibody RIA kits (Diagnostic Products Co., USA). The assays were performed in duplicate with an intra-and inter-assay coefficient of variation (CV) of 3-5% and 5-8% respectively. PRL values > 15.0 ng ml-' for males, > 20.0 ng ml-' for premenopausal and > 10.0 ng ml-' for postmenopausal females were considered for % elevation. CEA levels above 5.0 ng ml-' was regarded as % elevated.Criteria for positive tests were: continual rise in the marker level after an initial fall or persistent high level of the marker as an indicator of relapse and/or no response to treatment. Statistical analysisThe statistical significance of differences between various groups was calculated by Mann-Whitney U-test. a-value

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Section: Discussionmentioning

confidence: 98%

Comparison of plasma prolactin and CEA in monitoring patients with adenocarcinoma of colon and rectum

Patel²,

Giri³

et al. 1992

Br J Cancer

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“…It was concluded that more recurrences could be resected for cure among patients undergoing intensive follow-up compared with no or minimal follow-up. There was also a 9.1% (95% CI, '/2.2 to'/16.0%) higher 5-year survival rate favouring intensive follow-up, but only when CEA was included in the follow-up programme, which was the case in three studies (11,23,24). These three studies also included liver imaging.…”

Section: Meta-analysesmentioning

confidence: 97%

“…A large number of studies concerning follow-up after resection for colorectal cancer have been published, but most of them are non-randomized single cohort studies, and only a few are prospective randomized studies (7,16,18,25,26,94) or comparative cohort studies (11,15,17,24,91,93) (Table 3). The control groups in all the cohort studies are patients that partly or totally have refused to participate in the follow-up programme.…”

Section: Follow-up Studiesmentioning

confidence: 99%

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Follow-up after Colorectal Cancer Surgery

Ohlsson

Pålsson

2003

Acta Oncologica

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“…About 30% of patients with colorectal cancer who undergo potentially curative surgery develop a recurrence, and of those, 70% to 80% occur at a distant site (August et al, 1984;Ovaska et al, 1990).…”

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confidence: 99%