Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1980 Dec;192(6):747–751. doi: 10.1097/00000658-198012000-00010

The Use of Preoperative Plasma CEA Levels for the Stratification of Patients After Curative Resection of Colorectal Cancers

Robert Goslin, Glenn Steele Jr, John Macintyre, Robert Mayer, Paul Sugarbaker, Kathryn Cleghorn, Richard Wilson, Norman Zamcheck
PMCID: PMC1344975  PMID: 7447529

Abstract

One hundred forty-five patients with colorectal cancer were analyzed in order to correlate the preoperative plasma carcinoembryonic antigen (CEA) levels with the sites and times of disease recurrence. The median follow-up periods of these patients was 50 months (range 36-72 months). Twenty-one patients were found to have metastases at the time of their operation. None of the seven patients whose primary tumors were classified as Dukes/Kirklin A have had tumor recurrence. Seventeen per cent of the patients with Dukes/Kirklin B tumors have had tumor recurrences, and 63% of the patients with Dukes/Kirklin C colorectal primary tumors have had tumor recurrence. No correlation was found between preoperative CEA values and subsequent risk of tumor recurrence or times to recurrence among the patients with Dukes/Kirklin B colorectal primary cancers. In Dukes/Kirklin C patients, however, elevated preoperative CEA values predicted a higher risk of tumor recurrence. Ninety per cent of the patients (19/21) with preoperative CEA levels greater than 5.0 ng/ml have had relapses, with a median time of 17 months before disease recurrence. Only 39% (9/23) of the patients with Dukes/Kirklin C lesions and CEA levels less than 5 ng/ml have had relapses and there is insufficient follow-up data as yet to determine the median survival time. If those patients whose Dukes/Kirklin C primary tumors were poorly differentiated on histologic examination are excluded, the contrast between patients having CEA levels greater than 5.0 ng/ml and those having CEA levels less than 5 ng/ml is even more marked. Sixteen of the 18 remaining patients whose CEA levels were greater than 5.0 ng/ml prior to curative resection have had relapses as compared with only three of 15 patients whose preoperative CEA values were less than 5. We conclude, therefore, that CEA is an important factor in stratifying patients after curative resection of their Dukes/Kirklin C colorectal tumors.

Full text

PDF
747

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. ASTLER V. B., COLLER F. A. The prognostic significance of direct extension of carcinoma of the colon and rectum. Ann Surg. 1954 Jun;139(6):846–852. doi: 10.1097/00000658-195406000-00015. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Cutler S. J., Scotto J., Devesa S. S., Connelly R. R. Third National Cancer Survey--an overview of available information. J Natl Cancer Inst. 1974 Dec;53(6):1565–1575. [PubMed] [Google Scholar]
  3. Denk H., Tappeiner G., Eckerstorfer R., Holzner J. H. Carcinoembryonic antigen (CEA) in gastrointestinal and extragastrointestinal tumors and its relationship to tumor-cell differentiation. Int J Cancer. 1972 Sep 15;10(2):262–272. doi: 10.1002/ijc.2910100206. [DOI] [PubMed] [Google Scholar]
  4. Dhar P., Moore T., Zamcheck N., Kupchik H. Z. Carcinoembryonic antigen (CEA) in colonic cancer. Use in preoperative and postoperative diagnosis and prognosis. JAMA. 1972 Jul 3;221(1):31–35. [PubMed] [Google Scholar]
  5. Hansen H. J., Snyder J. J., Miller E., Vandevoorde J. P., Miller O. N., Hines L. R., Burns J. J. Carcinoembryonic antigen (CEA) assay. A laboratory adjunct in the diagnosis and management of cancer. Hum Pathol. 1974 Mar;5(2):139–147. doi: 10.1016/s0046-8177(74)80061-4. [DOI] [PubMed] [Google Scholar]
  6. Herrera M. A., Chu T. M., Holyoke E. D. Carcinoembryonic antigen (CEA) as a prognostic and monitoring test in clinically complete resection of colorectal carcinoma. Ann Surg. 1976 Jan;183(1):5–9. doi: 10.1097/00000658-197601000-00002. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Martin F., Martin M. S. Radioimmunoassay of carcinoembryonic antigen in extracts of human colon and stomach. Int J Cancer. 1972 May 15;9(3):641–647. doi: 10.1002/ijc.2910090322. [DOI] [PubMed] [Google Scholar]
  8. Steele G., Jr, Zamcheck N., Wilson R., Mayer R., Lokich J., Rau P., Maltz J. Results of CEA-initiated second-look surgery for recurrent colorectal cancer. Am J Surg. 1980 Apr;139(4):544–548. doi: 10.1016/0002-9610(80)90335-9. [DOI] [PubMed] [Google Scholar]
  9. Sugarbaker P. H., Skarin A. T., Zamcheck N. Patterns of serial CEA assays and their clinical use in management of colorectal cancer. J Surg Oncol. 1976;8(6):523–537. doi: 10.1002/jso.2930080612. [DOI] [PubMed] [Google Scholar]
  10. Wanebo H. J., Rao B., Pinsky C. M., Hoffman R. G., Stearns M., Schwartz M. K., Oettgen H. F. Preoperative carcinoembryonic antigen level as a prognostic indicator in colorectal cancer. N Engl J Med. 1978 Aug 31;299(9):448–451. doi: 10.1056/NEJM197808312990904. [DOI] [PubMed] [Google Scholar]
  11. Zamcheck N., Doos W. G., Prudente R., Lurie B. B., Gottlieb L. S. Prognostic factors in colon carcinoma: correlation of serum carcinoembryonic antigen level and tumor histopathology. Hum Pathol. 1975 Jan;6(1):31–45. doi: 10.1016/s0046-8177(75)80108-0. [DOI] [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES