Re-operation for recurrent colorectal cancer: the importance of early diagnosis for resectability and survival.
Between 1978 and 1986, 179 patients with recurrent colorectal cancer were treated and 137 patients were operated a second time.82.1% of the patients showed elevated CEA levels (greater than or equal to 5 ng/ml) at the time of diagnosis. In 58.1% of the patients the CEA increase preceded the recognition of recurrence, and in 13.4% the diagnosis could be confirmed only by a second-look operation. In 46.7% of the re-operated patients a potentially curative resection of the locally recurrent or metastatic disease could be performed. The resectability was significantly lower in patients with symptomatic recurrent disease (34.5%) as compared to asymptomatic patients with CEA-directed positive imaging (52.7%) and the second-look patients (62.5%) respectively. A significant improvement in survival could be achieved especially in the second-look operated patients.
Quentmeier
A
A
Department of Surgery, University of Heidelberg FRG.
Schlag
P
P
Smok
M
M
Herfarth
C
C
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000378:metabolism; D015179:Colorectal Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D011446:Prospective Studies; D012086:Reoperation; D015996:Survival Rate
D002272:Carcinoembryonic Antigen