[Elevated CEA values after cystectomy for bladder cancer and intestinal urinary diversion not evidence of tumor...

In the literature determination of carcino-embryonal antigen (CEA) in urine and plasma in bladder cancer patients reveals a positive rate between 40% and 80%. In the postoperative screening of radical cystectomized patients with intestinal urinary diversion high CEA levels gave primarily suspicion for tumor recurrence or metastases, however met-screenings were negative. In a prospective study 54 cystectomized bladder cancer patients with colonic conduit or ureterosigmoidoistomy were compared with cystectomized non-tumor-patients concerning the CEA levels in plasma and urine. Raised CEA-levels were obtained in more than 80% of the non-tumor-patients; urinary CEA was positive in 90% (m = greater than 2000 ng/ml), whereas only 3/5 patients with demonstrable tumor recurrence revealed raised CEA levels. The study shows significantly that determination of CEA in the postoperative screening care of bladder cancer patients with intestinal urinary diversion is not a useful tool in the armamentarium of tumor-screening.