Monitoring Carcinoembryonic Antigen in Colorectal Cancer: Is it Still Useful?

Abstract

The results of a study conducted to determine the usefulness of carcinoembryonic antigen (CEA) monitoring in the follow-up of patients with resected colorectal cancer are reported herein. The subjects of this study were 125 patients in whom CEA had been determined preoperatively and 239 patients in whom CEA had been monitored postoperatively. The results revealed increased preoperative CEA in only 24% of the subjects, and that this increment was correlated with subsequent more advanced tumor stage and a higher recurrence rate (P < 0.01). The postoperative CEA level exceeded the threshold in 71% of the patients affected by recurrence, 94.4% of whom developed liver metastases and 50%, nonhepatic recurrence. This marker showed elevated sensitivity for liver metastases (99%), whereas the sensitivity was lower for nonhepatic recurrence of the disease (94%). Thus, we concluded that CEA monitoring can be useful for preoperative colorectal tumor grading, even if its validity in the early diagnosis of recurrence is problematic, especially in terms of radical repeated surgery and survival.

Preoperative investigations for metastatic staging of colon and rectal cancer across multiple centres – what is current practice?

“…Sixty-four percent of patients (range 45-88% across centres) had a preoperative serum CEA level performed. CEA levels were found to be elevated (> 5 lg ⁄ l) in 35% of cases tested, which compares to 24-43% in previously reported series [51,52]. The frequency of CEA testing is lower than what we had expected; particularly as CEA testing is cheap, easily obtained and has a proven prognostic significance.…”

Long-Term Survival Achieved by Resection of Metastases in the Liver and Lung in a Patient with Recurrent Colonic Cancer: Report of a Case

“…1 The CEA level peaked before resection of the hepatic metastasis and was within the normal range at all other times. 5,6 These factors indicate that the degree of malignancy was relatively low despite the presence of metastatic ability.…”

Biliary carcinoembryonic antigen in the diagnosis of occult hepatic metastases from colorectal cancer

“…The results concerning the validity of CEA determination for early diagnosis of postoperative hepatic metastases have already been published [6,9]. Sensitivity, positive prognostic value (PPV) and diagnostic accuracy (DA) of biliary CEA in detecting hepatic metastases were determined in the entire study cohort.…”

“…Within this context, the carcinoembryonic antigen (CEA) has been the most studied and used tumor marker and, even in our experience [6], has been used with encouraging results during the postoperative follow-up period.…”