Original Research Article
Year: 2017 | Month: January | Volume: 7 | Issue: 1 | Pages: 10-14
CEA versus Other Diagnostic Modalities for Detection of Early Recurrent Disease after Curative Resection of Colorectal Cancer
Majlinda Kallco1, Prof. Elsa Kone2, DR. Xheladin Ceka2, Erinda Hoxhallari3
1Regional Hospital Durres.
2Department of Morphology, Faculty of Medicine.
3Medial Laboratory Center no 2, Tirana.
Corresponding Author: Majlinda Kallco
ABSTRACT
A high serum CEA is associated with a number of malignancies, including colorectal, breast, gastric and pancreatic cancers. Many studies have shown that increased preoperative serum CEA levels are associated with an increased risk of recurrence and a poor prognosis and the prognostic effect of the serum CEA level is independent of the tumor node-metastasis stage.
Aim of the study: To evaluate the detection rate of early recurrent disease by serial CEA measurements versus other diagnostic modalities in patients after curative resection of colorectal cancer, as part of postoperative surveillance.
Material and methods: In this study, we prospectively evaluated colorectal cancer patients who were diagnosed and operated between January 1st 2012 and December 31st 2014 in the Surgical Department of Oncology and Surgery in UHC “Mother Teresa”, Tirana. These patients underwent specified follow-up protocol that included: physical examination, including checking for tumor recurrence at wound sites; carcinoembryonic antigen (CEA) testing every 3 months for the first year and then every 6 months; chest radiography every 6 months for 2 years; and colon evaluation (colonoscopy), annually for the first year and then every 3 years if the colon was free of neoplasm. Recurrence was defined as either radiologic or pathologic evidence of tumor in the follow-up period. We compared the detection rate of early recurrent disease by serial CEA measurements versus other diagnostic modalities in patients after curative resection of colorectal cancer.
Results: In the evaluation of CEA detection rate versus other diagnostic modalities, we noticed a difference for a better detection rate in comparison with CT scans (33.3% vs. 23.8%; P=.747), colonoscopy (33.3% v.s. 14.2%; P=.308), Chest X-ray (33.3% vs. 9.5%; P=.159) and physical findings (33.3% v.s. 9.5%; P=.159). These differences were not statistically significant.
Conclusions: Intensive monitoring of colorectal cancer recurrence for both patient with early stages and patients with advanced stages with measurement of CEA appears to be cost-effective and superior to other diagnostic modalities.
Key words:CEA, recurrence, colorectal cancer.