Prognostic value of preoperative serum CEA level compared to clinical staging: III. An approach to scoring of prognostic factors in colorectal cancer

Brümmendorf, T.; Anderer, F. A.; Staab, H. J.; Hornung, A.; Stumpf, E; Kieninger, G.

doi:10.1002/jso.2930280405

Cited by 8 publications

(4 citation statements)

References 19 publications

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“…CEA, detected almost 30 years ago (Gold and Freedman, 1965), is the only clinically established marker for preoperative diagnosis and follow-up of patients with colorectal cancer (Brummendorf et al, 1985;Roberts, 1988;Minton and Chevinsky, 1989;Kuusela et al, 1991). Because of a low sensitivity in early stages of colorectal cancer, CEA is not an ideal marker for preoperative diagnosis (Brummendorf et al, 1985;Roberts, 1988;Kuusela et al, 1991;Nilsson et al,1992).…”

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Preoperative serum levels of CEA and CA 242 in colorectal cancer

Carpelan-Holmström

Haglund²,

Kuusela³

et al. 1995

Br J Cancer

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Summary Preoperative serum levels of CEA and CA 242 were determined in 260 patients with colorectal cancer and in 92 patients with benign colorectal diseases. The overall sensitivity of the CEA test was 43% and of the CA 242 test 39%. The corresponding specificities were 90% and 87% respectively, using 5 ng ml-' as cut-off level for CEA and 20 U ml-' for CA 242. The sensitivity of CEA was 26%, 32%, 38% and 77% for Dukes A, B, C and D colorectal cancer, and the sensitivity of CA 242 was 26%, 26%, 40% and 67%, respectively. The correlation between CEA and CA 242 was low. Concomitant elevation of both markers was seen in 5%, 12%, 18% and 59% of patients with Dukes A, B, C and D colorectal cancer, respectively. Of all the patients, 23% showed elevation of both the CEA and the CA 242 level, whereas CEA alone was elevated in 20% and CA 242 alone in 15% of the patients with colorectal cancer. Combined use of both markers raised the overall sensitivity from 43% to 58%, but reduced the specificity from 90% to 80%. The increase in sensitivity by combining the two markers was most marked in Dukes A, B and C colorectal cancer. Either or both of the markers were elevated in 46%, 46% and 60% of the patients respectively. The clinical value of combining CEA and CA 242 seems very promising and should be further investigated in prospective studies.

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“…Because of a low sensitivity in early stages of colorectal cancer, CEA is not an ideal marker for preoperative diagnosis (Brummendorf et al, 1985;Roberts, 1988;Kuusela et al, 1991;Nilsson et al,1992). However, CEA shows high sensitivity for recurrent colorectal cancer.…”

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confidence: 99%

Preoperative serum levels of CEA and CA 242 in colorectal cancer

Carpelan-Holmström

Haglund²,

Kuusela³

et al. 1995

Br J Cancer

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“…Zamcheck N, Doos WG, Prudente R, Lurie BB, Gottlieb L,S: of parameters as long as they provide additional prognostic information to each other. A first approach was made by scoring of prognostic factors [21]. However, further extensive studies might reveal other criteria of more comprehensive prognostic value.…”

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confidence: 99%

Prognostic value of preoperative serum cea level compared to clinical staging IV. Histological grading and tumor type in colorectal and gastric cancer

Bogenschütz

Brümmendorf

Staab

et al. 1986

Journal of Surgical Oncology

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In a clinical investigation of observed postoperative survival, 410 patients with colorectal cancer and 269 patients with stomach cancer have been registered for primary surgical treatment connected with a long-term follow up. Histologic grading and tumor typing were examined as potential prognostic factors and compared with the prognostic information covered by operability, tumor extension, and the preoperative CEA level. Statistical treatment of the data revealed no prognostic significance of the tumor types adenocarcinoma, mucinous, and anaplastic tumours in gastric cancer. Histologic grading specified ranges associated with significant differences in survival of gastric and colorectal cancer patients. However, histologic grading did not provide prognostic information in addition to operability and tumor extension. However, histologic grading gave additional prognostic information to preoperative CEA levels in the range of 0-5 micrograms CEA/1 serum but not in the range greater than 5 micrograms CEA/1. The results indicate that the prognostic information of preoperative serum CEA level is not directly linked to the histologic grade of a tumor.

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“…Chirurgische Radikalität ist ein hoch signifikanter prognostischer Faktor (3, 8, 20). In unserem Krankenkollektiv scheint es einen wichtigen Zusammenhang zu geben, der uns vorauszusetzen erlaubt, dass eine kurative Operation bei dem normalen präoperativen CEA‐Wert mit 91%iger Wahrscheinlichkeit möglich ist.…”

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Der praoperative CEA-Wert als ein prognostischer Faktor

Pechán

Okolièany

et al. 2001

European Surg

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Zusammenfassung: Grundlagen: In zwei Patientenkollektiven wurde die Bedeutung des präoperativen CEA‐Wertes beim kolorektalen Karzinom untersucht.  Methodik: In einer retrospektiven Studie wurden in der Zeit vom 1. 1. 1986 bis 31. 12. 1995 sowohl die Krankenblattunterlagen als auch Ergebnisse von aktuellen Nachuntersuchungen der Patienten der II. Chirurgischen Universitätsklinik, Bratislava analysiert. Parallel dazu wurden die Krankengeschichten der Patienten untersucht, welche an der Klinik für Allgemein‐und Unfallchirurgie HHU in Düsseldorf im Zeitraum vom 1. 1. 1986 bis 31. 12. 1993 behandelt wurden.  Ergebnisse: Von allen 777 Patienten wurden präoperative CEA‐Werte bei 406 Patienten untersucht. Davon hatten 206 Patienten erhöhte CEA‐Werte. In der Gruppe mit negativen präoperativen CEA‐Werten war eine R0‐Resektion in 91 % möglich. Die Sensitivität des präoperativen CEA‐Wertes steigt von 36,3 % bei den Patienten ohne regionäre Lymphknotenmetastasen bis auf 72,7 % mit positiven regionären Lymphknoten. In dem Patientenkollektiv mit negativem CEA‐Wert zeigen 78 % eine N0‐Situation. Patienten mit Fernmetastasen hatten in 88,4 % erhöhte präoperative CEA‐Werte. Bei normalem präoperativem CEA‐Wert liegt die Rate der Fernmetastasen bei 5 %.  Schlussfolgerungen: Wir empfehlen die präoperativen CEA‐Werte zu untersuchen. Das ergänzt das Staging und ein negativer Wert ist ein wichtiger prognostischer Faktor für das pN‐ und das pM‐Stadium, für die Radikalität des Eingriffes und für die Überlebenszeiten.

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Prognostic value of preoperative serum CEA level compared to clinical staging: III. An approach to scoring of prognostic factors in colorectal cancer

Cited by 8 publications

References 19 publications

Preoperative serum levels of CEA and CA 242 in colorectal cancer

Preoperative serum levels of CEA and CA 242 in colorectal cancer

Prognostic value of preoperative serum cea level compared to clinical staging IV. Histological grading and tumor type in colorectal and gastric cancer

Der praoperative CEA-Wert als ein prognostischer Faktor

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