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Serum Levels Before and After Resection and Before Recurrence

David Z. J. Chu, MD; Curtis A. Erickson, MD; M. Patricia Russell, MA; Carolyn Thompson, MS; Nicholas P. Lang, MD; Ralph J. Broadwater, MD; Kent C. Westbrook, MD

Arch Surg. 1991;126(3):314-316.

Abstract
• The use of carcinoembryonic antigen was evaluated in 425 patients with a mean follow-up of 48 months. The preoperative and postoperative carcinoembryonic antigen levels were predictive of recurrence and survival independent of the tumor stage. In a multivariate regression analysis of age, location, tumor stage, and preoperative and postoperative carcinoembryonic antigen levels, the latter three factors were significant prognostic variables with respect to the adjusted survival. Recurrent disease was found in 42% of patients, excluding patients with stage IV disease. The carcinoembryonic antigen level at recurrence was greater than 5 ng/mL in 79% of the patients and in 89% of the intraabdominal recurrences. Carcinoembryonic antigen level at recurrence was not predictive of postrecurrence survival except in the subgroup of locoregional disease. The life span in patients with liver and lung metastases was not influenced by carcinoembryonic antigen level at recurrence. Preoperative and postoperative carcinoembryonic antigen levels can indicate a poorer prognostic group of patients with colorectal cancer who may benefit from adjuvant treatment. The carcinoembryonic antigen at recurrence can be used effectively to diagnose intra-abdominal recurrences and project survival after development of local/regional disease.

(Arch Surg. 1991;126:314-316)

Author Affiliations
From the Departments of Surgery (Drs Chu, Erickson, Lang, Broadwater, and Westbrook and Ms Russell) and Biostatistics (Ms Thompson), University of Arkansas for Medical Sciences, Little Rock, and the McClellan Veterans Affairs Hospital, Little Rock.

Footnotes
Accepted for publication November 17, 1990.

Read before the 43rd Annual Cancer Symposium of the Society of Surgical Oncology, Washington, DC, May 21, 1990.

Reprint requests to The Permanente Medical Group, 260 International Circle, San Jose, CA 95119 (Dr Chu).

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