Computed tomography in recurrent or metastatic colon cancer: relation to rising serum carcinoembryonic antigen

Twenty patients with Stage Duke B or C adenocarcinoma of the colon or rectum who have undergone radical surgical resection and demonstrated rising serum carcinoembryonic antigen (CEA) during follow-up are the subject of this study. In all cases, while there was a continuous and progressive elevation of serum CEA, CT examination of the abdomen and pelvis was performed. Abnormal CT findings were demonstrated in 19 patients and included pelvic mass, liver metastases, and periaortic or mesenteric lymphadenopathy. There was one normal CT scan in a patient who subsequently developed metastases in the sacrum. Based on the observations in these patients, it is concluded that in routine follow-up after colorectal surgery, rising serum CEA should be considered a warning sign and warrants additional investigation by CT.