caa a22 4500 475790944 CHVBK 20180406123710.0 cr unu---uuuuu 170329e20000701xx s 000 0 eng 10.1007/s004230000136 doi (NATIONALLICENCE)springer-10.1007/s004230000136 The role of carcinoembryonic antigen for the detection of recurrent disease following curative resection of large-bowel cancer [Elektronische Daten] [Matthias W. Wichmann, Christian Müller, Ulla Lau-Werner, Tim Strauss, Reinhold A. Lang, Hans M. Hornung, Petra Stieber, Friedrich-Wilhelm Schildberg] Background and aims: During recent years, a discussion about cost-effectiveness and importance of follow-up evaluation after curative resection of large-bowel cancer has developed. It is not known whether the determination of carcinoembryonic antigen (CEA) plays a crucial role in the early detection of recurrent disease. Patients/methods: We conducted an analysis of the prospective follow-up database of 1321 patients after curative resection of colorectal cancer in our institution between 1990 and 1998 to evaluate the role of CEA in the early detection of recurrent disease. Results: Of the 1321 patients included in our study, 306 developed recurrent disease following curative resection (23.2%). These patients with recurrent disease were divided into: Group I. No pre-operative CEA determination/insufficient follow-up (n=47; 15.4%). Group II. No elevation of CEA with primary cancer (n=156; 51.0%): (IIa) elevation with recurrent disease (n=62); (IIb) no elevation at any time point (n=53); and (IIc) role of CEA not completely elucidated (n=41). Thirteen patients of group II underwent curative relapse surgery (8.3%). Group III. Elevated CEA with primary cancer (n=103; 33.7%): (IIIa) no increase with recurrent disease (n=21); (IIIb) increase with other symptoms of recurrent disease (n=45); and (IIIc) increased values as an early symptom of recurrent disease (n=37). Sixteen patients of group III underwent curative relapse surgery (15.5%). In patients after relapse surgery, recurrent disease developed again after a median time of 12months (mean 17.9±3.8months). Conclusions: Our findings indicate that 2.8% of all patients (12.1% of patients with recurrent disease) who underwent curative resection of colorectal cancer profit from follow-up CEA determinations. With careful observation of CEA kinetics, 6.2% (n=82) of all patients or 26.8% of patients with recurrent disease could profit from routine follow-up CEA determinations. In 9.5% of patients with recurrent disease, curative resection of relapse was achieved and these patients remained disease free for a median time of 12months. Regular CEA measurements remain an important part of routine patient care after curative resection of colorectal cancer. Springer-Verlag, 2000 Carcinoembryonic antigen Colorectal cancer Recurrent disease Follow-up Clinical study nationallicence Wichmann Matthias W. Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut Müller Christian Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut Lau-Werner Ulla Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut Strauss Tim Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut Lang Reinhold A. Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut Hornung Hans M. Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut Stieber Petra Institute for Clinical Chemistry, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany, Germany aut Schildberg Friedrich-Wilhelm Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut Langenbeck's Archives of Surgery Springer-Verlag 385/4(2000-07-01), 271-275 1435-2443 385:4<271 2000 385 423 https://doi.org/10.1007/s004230000136 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s004230000136 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Wichmann Matthias W. Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut NATIONALLICENCE 700 1- Müller Christian Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut NATIONALLICENCE 700 1- Lau-Werner Ulla Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut NATIONALLICENCE 700 1- Strauss Tim Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut NATIONALLICENCE 700 1- Lang Reinhold A. Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut NATIONALLICENCE 700 1- Hornung Hans M. Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut NATIONALLICENCE 700 1- Stieber Petra Institute for Clinical Chemistry, Ludwig-Maximilians-University, Klinikum Grosshadern, Munich, Germany, Germany aut NATIONALLICENCE 700 1- Schildberg Friedrich-Wilhelm Department of Surgery, Ludwig-Maximilians-University, Klinikum Grosshadern, Marchioninistrasse 15, D-81377 Munich, Germany, Germany aut NATIONALLICENCE 773 0- Langenbeck's Archives of Surgery Springer-Verlag 385/4(2000-07-01), 271-275 1435-2443 385:4<271 2000 385 423 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer