[Effect of serial CEA determination on diagnosis, therapy and prognosis of recurrent colorectal cancer]

Abstract

A rising CEA level did not indicate an early tumour recurrence in the follow-up of 660 patients with curative surgery because of colorectal carcinoma. In case of rectal carcinoma the first rise of the tumour marker preceded diagnosis of recurrence by other means 7.9 months on an average, in case of colonic carcinoma 5.1 months. The long-term survival after secondary procedure was 17.5% for patients with normal CEA value at time of reoperation and surmounted life expectancy of patients with rising tumour-marker level significantly (5.9%). The worst prognosis was found for the collective with rising CEA before diagnosis of relapse by other means, none of whom was saved by reoperation. The resectability rate of metastases was higher than that of local recurrences with nearly identical survival for both groups. Because of the long CEA lead times advances in therapy by second-look procedures are to be expected mainly for patients with pelvic recurrences after abdominoperineal extirpation.