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Tumor markers in patients with relapse of colorectal carcinoma
Ludmila Lipská1, Vladimir Visokai, Miroslav Levý
1Department of Surgery, Charles University, First Medical Faculty and Thomayer Teaching Hospital, Prague, Czech Republic. ludmila.lipska@ftn.cz
Aim:
To evaluate CEA and CA19-9 in a long-term follow-up after radical surgery for colorectal cancer.
Patients And Methods:
A total of 1,090 patients were operated on for colorectal cancer, 716 patients underwent R0 resection, 631 patients were under further surveillance, relapse was diagnosed in 122 patients (20%), 74 patients were indicated for reoperation The resectability of the relapse was 35%. An AxSYM instrument (Abbott) was used for analysis.
Results:
At the time of relapse both markers were normal in 31% of the patients. When relapse was diagnosed, in patients with normal preoperative levels, CEA and CA19-9 were below cut-off in 48% and 79%, respectively, and in those with primary elevation, they were again elevated in 78% and 64%, respectively.
Conclusion:
The surveillance based only on CEA and/or CA19-9 was cost-effective, but failed to disclose 1/3 of patients suffering from relapse; these markers must be combined with liver and chest imaging methods and colonoscopy.
