Second look in colorectal surgery

Bucci, Luigi; Benassai, Giacomo; Santoro, G. A.

doi:10.1007/bf02048444

Cited by 6 publications

(2 citation statements)

References 24 publications

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“…Out of all the investigations used in follow up, CEA is the test that patients are most compliant with [22]. Patients with CEA levels of <11 ng/ml undergoing second look surgery have a higher resectability rate [27] whereas patients with high levels of CEA usually have unresectable disease [28].…”

Section: Discussionmentioning

confidence: 99%

A small rise in CEA is sensitive for recurrence after surgery for colorectal cancer

2007

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If CEA is measured after surgery for colorectal cancer, a rise of >1 in the patient's postoperative value is predictive for recurrence or metastases with an overall sensitivity of 80% and specificity of 86%. Previous studies have recognized the role of large rises in CEA in predicting recurrence but this study shows that small changes in CEA may be significant even if these levels would be traditionally within 'normal' limits.

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Section: Discussionmentioning

confidence: 99%

A small rise in CEA is sensitive for recurrence after surgery for colorectal cancer

2007

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“…Potential contraindications depending on severity of presentation include obesity, and acute abdomen with ileus 3. Bucci et al stated in 1994 that the serum tumor marker CEA (carcinoembryonic antigen) -directed second-look surgery is not a reliable or cost-effective approach 22. An elevated serum CEA today prompts cross sectional and functional diagnostic imaging, which as discussed previously, is typically unrevealing for PSM of CRC origin.…”

Section: High Risk Factors Which May Be Responsible For Early Recurrmentioning

confidence: 99%

Patients at Risk for Peritoneal Surface Malignancy of Colorectal Cancer Origin: The Role of Second Look Laparotomy

Brücher¹,

Stojadinovic²,

Bilchik³

et al. 2013

J. Cancer

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Peritoneal surface malignancy (PSM) is a frequent occurrence in the natural history of colorectal cancer (CRC). Although significant advances have been made in screening of CRC, similar progress has yet to be made in the early detection of PSM of colorectal cancer origin. The fact that advanced CRC can be confined to the peritoneal surface without distant dissemination forms the basis for aggressive multi-modality therapy consisting of cytoreductive surgery (CRS) plus hyperthermic intra-peritoneal chemotherapy (HIPEC), and neoadjuvant and/or adjuvant systemic therapy. Reported overall survival with complete CRS+HIPEC exceeds that of systemic therapy alone for the treatment of PSM from CRC, underscoring the advantage of this multi-modality therapeutic approach. Patients with limited peritoneal disease from CRC can undergo complete cytoreduction, which is associated with the best reported outcomes. As early or limited peritoneal carcinomatosis is undetectable by conventional imaging modalities, second look laparotomy is an important means to identify disease in high-risk patients at a stage most amenable to complete cytoreduction. This review focuses on the identification of patients at risk for PSM from CRC and discusses the role of second look laparotomy.

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Blood CEA levels for detecting recurrent colorectal cancer

Nicholson

Shinkins

Pathiraja

et al. 2015

Cochrane Database of Systematic Reviews

159

149

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CEA is insufficiently sensitive to be used alone, even with a low threshold. It is therefore essential to augment CEA monitoring with another diagnostic modality in order to avoid missed cases. Trying to improve sensitivity by adopting a low threshold is a poor strategy because of the high numbers of false alarms generated. We therefore recommend monitoring for colorectal cancer recurrence with more than one diagnostic modality but applying the highest CEA cut-off assessed (10 µg/L).

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Second look in colorectal surgery

Cited by 6 publications

References 24 publications

A small rise in CEA is sensitive for recurrence after surgery for colorectal cancer

A small rise in CEA is sensitive for recurrence after surgery for colorectal cancer

Patients at Risk for Peritoneal Surface Malignancy of Colorectal Cancer Origin: The Role of Second Look Laparotomy

Blood CEA levels for detecting recurrent colorectal cancer

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