Postsurgical surveillance for recurrence of UICC stage I colorectal carcinoma: is follow-up by CEA justified?
OBJECTIVE
This study was undertaken to investigate whether it will be possible to reduce the times and types of postoperative examinations for surveillance in patients with UICC stage I colorectal carcinoma. In addition, the value of CEA in postoperative surveillance is discussed.


METHODS
A review was performed of 541 patients who underwent curative resection for UICC stage I colorectal carcinoma between January, 1985 and December, 1998. Periodic check-up was routinely conducted to identify recurrence.


RESULTS
The median follow-up was 82 months. The recurrence rate was 2.9% in the UICC stage Ia (pT1N0M0) group, and 5.6% in the Ib (pT2N0M0) group. Cancer-specific survival rates at 5 years were 99.3% and 97.6%, respectively (p=0.0354). Recurrences occurred more frequently in patients with lower rectal carcinoma (p=0.0415). Curative-intent salvage surgery was performed in 61.9% (13/21) for recurrent lesions. Between the patients who were CEA positive (13/21; 61.9%) and those who were CEA negative at the time of recurrence, there was no significant difference in the prognosis.


CONCLUSIONS
The incidence of recurrence was low after curative surgery in patients with UICC stage I colorectal carcinoma, and it is therefore possible to reduce times and types of postoperative examinations. CEA measurement alone appears to be sufficient.
Yamamoto
Seiichiro
S
Division of Colorectal Surgery, National Cancer Center Hospital, Tokyo, Japan. seyamamo@ncc.go.jp
Akasu
Takayuki
T
Fujita
Shin
S
Moriya
Yoshihiro
Y
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002277:Carcinoma / Q000097:blood / Q000473:pathology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000097:blood / Q000473:pathology / Q000601:surgery*; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood* / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D009367:Neoplasm Staging; D011159:Population Surveillance; D011184:Postoperative Period; D012189:Retrospective Studies; D016019:Survival Analysis
D002272:Carcinoembryonic Antigen