Tumor markers in patients with relapse of colorectal carcinoma.
OBJECTIVE
To evaluate CEA and CA19-9 in a long-term follow-up after radical surgery for colorectal cancer.


METHODS
A total of 1,090 patients were operated on for colorectal cancer, 716 patients underwent R0 resection, 631 patients were under further surveillance, relapse was diagnosed in 122 patients (20%), 74 patients were indicated for reoperation The resectability of the relapse was 35%. An AxSYM instrument (Abbott) was used for analysis.


RESULTS
At the time of relapse both markers were normal in 31% of the patients. When relapse was diagnosed, in patients with normal preoperative levels, CEA and CA19-9 were below cut-off in 48% and 79%, respectively, and in those with primary elevation, they were again elevated in 78% and 64%, respectively.


CONCLUSIONS
The surveillance based only on CEA and/or CA19-9 was cost-effective, but failed to disclose 1/3 of patients suffering from relapse; these markers must be combined with liver and chest imaging methods and colonoscopy.
Lipská
Ludmila
L
Department of Surgery, Charles University, First Medical Faculty and Thomayer Teaching Hospital, Prague, Czech Republic. ludmila.lipska@ftn.cz
Visokai
Vladimir
V
Levý
Miroslav
M
Svobodová
Sárka
S
Kormunda
Stanislav
S
Fínek
Jindrich
J
D014408:Biomarkers, Tumor / Q000097:blood*; D018395:CA-19-9 Antigen / Q000097:blood; D002272:Carcinoembryonic Antigen / Q000097:blood; D015179:Colorectal Neoplasms / Q000097:blood* / Q000473:pathology*; D005500:Follow-Up Studies; D006801:Humans; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D009367:Neoplasm Staging; D012189:Retrospective Studies
D014408:Biomarkers, Tumor; D018395:CA-19-9 Antigen; D002272:Carcinoembryonic Antigen