Abdominal exploration for suspected recurrent carcinoma of the colon and rectum based upon elevated carcinoembryonic antigen alone or in combination with other diagnostic methods

Abstract

Thirty-six patients underwent abdominal exploration due to elevated carcinoembryonic antigen (CEA) levels after a curative resection for carcinoma of the colon and rectum. Three groups were evaluated. In group 1, CEA elevation alone was the indication for the exploration in 13 asymptomatic patients. In group 2, 13 other asymptomatic patients underwent exploration because of elevated CEA levels in combination with other findings. In group 3, ten patients were symptomatic with an elevated CEA level at the time of exploration. Five patients from groups 1 and 2 underwent a curative resection for recurrent tumor (14 per cent). Three of these patients are still alive more than five years after exploration. Nine patients had negative findings at exploration for tumor recurrence (25 per cent false-positive results). Six of these patients are alive while three have died of metastatic disease. Twenty-two of the 36 patients (61 per cent) had unresectable disease at the time of exploration. Four of these patients underwent some form of surgical palliative procedure. Considering the five patients who underwent a curative resection with the latter four patients, this results in 25 per cent of the patients benefitting from surgical exploration.