Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2023 Mar 22;38(1):75.
doi: 10.1007/s00384-023-04356-2.

Is frequent measurement of tumor markers beneficial for postoperative surveillance of colorectal cancer?

Mitsuru Yokota  1 , Akitaka Morikawa  2 , Hiroya Matsuoka  2 , Jun Muto  2 , Kazuki Hashida  2 , Yoshio Nagahisa  2 , Toshihiko Masui  2 , Michio Okabe  2 , Hirohisa Kitagawa  2 , Kazuyuki Kawamoto  2
Affiliations

Is frequent measurement of tumor markers beneficial for postoperative surveillance of colorectal cancer?

Mitsuru Yokota et al. Int J Colorectal Dis. .

Abstract

Purpose: To determine whether frequent measurement of tumor markers triggers early detection of colorectal cancer recurrence.

Methods: Of 1,651 consecutive patients undergoing colorectal cancer surgery between 2010 and 2016, 1,050 were included. CEA and CA 19-9 were considered to be postoperative tumor markers and were measured every 3 months for 3 years, and then every 6 months for 2 years. Sensitivity analysis of elevated CEA and CA19-9 levels and multivariate analysis of factors associated with elevated CEA and CA19-9 levels were performed. The proportion of triggers for detecting recurrence was determined.

Results: The median follow-up period was 5.3 years. After applying the exclusion criteria, 1,050 patients were analyzed, 176 (16.8%) of whom were found to have recurrence. After excluding patients with persistently elevated CEA and CA19-9 levels before and after surgery from the 176 patients, 71 (43.6%) of 163 patients had elevated CEA levels and 35 (20.2%) of 173 patients had elevated CA19-9 levels. Sensitivity/positive predictive values for elevated CEA and CA19-9 levels at recurrence were 43.6%/32.3% and 20.2%/32.4%, respectively. Lymph node metastasis was a factor associated with both elevated CEA and CA19-9 levels at recurrence. Of the 176 patients, computed tomography triggered the detection of recurrence in 137 (78%) and elevated tumor marker levels in 13 (7%); the diagnostic lead interval in the latter 13 patients was 1.7 months.

Conclusion: Tumor marker measurements in surveillance after radical colorectal cancer resection contribute little to early detection, and frequent measurements are unnecessary for stage I patients with low risk of recurrence.

Keywords: CA19-9; CEA; Colorectal cancer; Postoperative surveillance.

PubMed Disclaimer

References

    1. Sung H, Ferlay J, Siegel RL et al (2021) Global cancer statistics 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 71:209–249 - DOI - PubMed
    1. Cancer Statistics. Cancer Information Service, National Cancer Center, Japan (National Cancer Registry, Ministry of Health, Labour and Welfare). Accessed 8 Aug 2022
    1. Biller LH, Schrag D (2021) Diagnosis and treatment of metastatic colorectal cancer: a review. JAMA 325:669–685 - DOI - PubMed
    1. Rodríguez-Moranta F, Saló J, Arcusa A et al (2006) Postoperative surveillance in patients with colorectal cancer who have undergone curative resection: a prospective, multicenter, randomized, controlled trial. J Clin Oncol 24:386–393 - DOI - PubMed
    1. Tjandra JJ, Chan MK (2007) Follow-up after curative resection of colorectal cancer: a meta-analysis. Dis Colon Rectum 50:1783–1799 - DOI - PubMed

LinkOut - more resources