Usefulness of CEA Concentration Measurement and Classic Colonoscopy in Follow-Up After Radical Treatment of Colorectal Cancer

• Authors: Zbigniew Banaszkiewicz , Paweł Jarmocik , Jacek Frasz , Krzysztof Tojek , Marcin Mrozowski , Arkadiusz Jawień
• Languages of publication: EN

Abstracts

EN

There is always a certain rate of recurrence after radical treatment for cancer and to get on it an early detection of disease set back is crucial.Material and methods. Medical data of patients operated on for primarily detected colorectal cancer in years 1993-2002 was retrospectively reviewed. Usefulness of follow-up means such as physical examination, or CEA and endoscopic surveillance was analyzed. All mentioned above were applied to scheduled follow-up (in 3, 6 and 12 month intervals following an operation and annually after that by the year 5).Results. Complete and reliable data was obtained from 340 out of 502 follow-up intended subjects (67.7%). Elevated CEA was the most frequent predictor of recurrence within non-symptomatic subjects meeting follow-up appointments (60%). The cancer set back diagnosed by means of either physical or endoscopic examinations was the case only in one out of five patients (20.75% and 18.87% respectively). Clinical onset of recurrence making patients meet an unscheduled appointment was found increasing relative risk of nothing-but-palliative option either for them with local set back, or meta-static spread. Relative risk of onset of meta-chronous colonic cancer was significantly higher in patients being affected by synchronous advanced adenoma at time of surgery compared to those with one-fold changes.Conclusions. CEA scheduled follow-up after treatment for colorectal cancer CRC seems adequate to provide a good outcome of treatment for recurrent tumors. CRC patients presenting with synchronous advanced adenomas at time of surgery are probably to be under more intensive endoscopic surveillance.

Keywords

EN

colorectal cancer; follow-up; CEA; colonoscopy

• Publisher: De Gruyter Open
• Journal: Polish Journal of Surgery
• Year: 2011
• Volume: 83
• Issue: 6
• Pages: 310-318

Dates

published

1 - 6 - 2011

online

25 - 7 - 2011

Contributors

author

Zbigniew Banaszkiewicz

• Department of Surger, Collegium Medicum Nicolaus Copernicus University in Bydgoszcz

author

Paweł Jarmocik

• Department of Surger, Collegium Medicum Nicolaus Copernicus University in Bydgoszcz

author

Jacek Frasz

• Department of Surger, Collegium Medicum Nicolaus Copernicus University in Bydgoszcz

author

Krzysztof Tojek

• Department of Surger, Collegium Medicum Nicolaus Copernicus University in Bydgoszcz

author

Marcin Mrozowski

• Department of Surger, Collegium Medicum Nicolaus Copernicus University in Bydgoszcz

author

Arkadiusz Jawień

• Department of Surger, Collegium Medicum Nicolaus Copernicus University in Bydgoszcz

References

• Degowska M, Rydzewska G: Chemoprewencja raka jelita grubego - rola mesalazyny. Przegl Gastroenterol 2008; 3(5): 247-54.
• Hashiguchi Y, Ueno H, Kobayashi H: Surveillance after curative resection for colorectal cancer. Nippon Geka Gakkai Zasshi 2007; 108(3): 125-30.
• Tjandra JJ, Chan MK: Follow-up after curative resection of colorectal cancer: a meta-analysis. Dis Colon Rectum 2007; 50(11): 1783-99.[PubMed][Crossref]
• Wichmann MW, Lau-Werner U, Müller C: Carcinoembryonic antigen for the detection of recurrent disease following curative resection of colorectal cancer. Anticancer Res 2000; 20(6D): 4953-55.[PubMed]
• Wangesteen OH, Lewis FJ, Arhelger SW: An interim report upon the second-look procedure for cancer of the stomach, colon and rectum and for limited intraperitoneal carcinosis. Surg Gynecol Obstet 1954; 99: 257.
• Vernava AM, Longo WE, Virgo KS: Current follow-up strategies after resection of colon cancer. Results of a survey of members of the American Society of Colon and Rectal Surgeons. Dis Colon Rectum 1994; 37(6): 573-83.[Crossref][PubMed]
• Connor S, Frizelle FA, Bagshaw PF: Follow-up after attempted curative surgery for colorectal cancer; postal survey of New Zealand surgeons' practice. N Z Med J 2001; 13: 151-53.
• Asgeirsson T, Zhang S, Senagore AJ: Optimal follow-up to curative colon and rectal cancer surgery: how and for how long? Surg Oncol Clin N Am 2010; 19(4): 861-73.[WoS][PubMed][Crossref]
• Papagrigoriadis S, Heyman B: Patients' views on follow up of colorectal cancer: implications for risk communication and decision making. Postgrad Med J 2003; 79(933): 403-07.
• Figueredo A, Rumble RB, Maroun J: Follow-up of patients with curatively resected colorectal cancer: a practice guideline. BMC Cancer 2003; 6(3): 26.[Crossref]
• Renehan AG, Egger M, Saunders MP: Impact on survival of intensive follow up after curative resection for colorectal cancer: systematic review and meta-analysis of randomised trials. BMJ 2002; 6: 324(7341): 813.
• Jeffery GM, Hickey BE, Hider P: Follow-up strategies for patients treated for non-metastatic colorectal cancer. Syst Rev 2002; 1: 1-29.[WoS]
• Borie F, Combescure C, Daurès JP: Cost-effectiveness of two follow-up strategies for curative resection of colorectal cancer: comparative study using a Markov model. World J Surg 2004; 28(6): 563-69.[PubMed]
• Tindra JJ, Chan MK: Follow-up after curative resection of colorectal cancer: a meta-analysis". Dis Colon Rectum 2007; 50(11): 1783-99.
• Lucha PA, Rosen L, Olenwine J: Value of carcinoembrionicantigen monitoringin curative surgery for recurrent colorectal cancer. Dis Colon Rectum 1997; 40: 145-49.[PubMed][Crossref]
• Carethers JM: Secondary Prevention of Colorectal Cancer: Is There an Optimal Follow-up for Patients with Colorectal Cancer? Curr Colorectal Cancer Rep 2010; 6(1): 24-29.[PubMed][Crossref]
• Desch CE, Benson AB, Somerfield MR: Colorectal cancer surveillance: 2005 update of an American Society of Clinical Oncology practice guideline. J Clin Oncol 2006; 24(7): 1224-31.
• Cairns SR, Scholefield JH, Steele RJ: Guidelines for colorectal cancer screening and surveillance in moderate and high risk groups (update from 2002). Gut 2010; 59(5): 666-89.
• Spratlin JL, Hui D, Hanson J: Community compliance with carcinoembryonic antigen: follow-up of patients with colorectal cancer Clin Colorectal Cancer 2008; 7(2): 118-25.[WoS]
• Jeffery M, Hickey BE, Hider PN: Follow-up strategies for patients treated for non-metastatic colorectal cancer. Syst Rev 2007; 24(1): CD002200.[WoS]
• Coriat R, Mahboubi A, Lejeune C How do gastroenterologists follow patients with colorectal cancer after curative surgical resection? A three-year population-based study" Gastroenterol Clin Biol 2007 Nov; 31(11): 950-55.[Crossref][WoS]
• Balani A, Turoldo A, Roseano M: Role of intensive follow-up in colorectal cancer surgery patients Tumori 2003 Jul-Aug; 89(4 Suppl): 90-94.[PubMed]
• Simpson H, Jeffery M, Hickey B: Postoperative follow-up strategies for patients after potentially curative surgery for colorectal cancer at Christchurch Hospital. N Z Med J 2004 May; 7 117: (1193).
• Veingerl B: Serum carcinoembryonic antigen levels in patients operated for colorectal carcinoma. Wien Klin Wochenschr 2001; 113 Suppl 3: 32-38.
• Wang JY, Tang R, Chicag JM: Valve of carcinoembryonic antygen In the management of colorectal cancer. Dis Colon Rectum 1994; 37: 272-77.[Crossref]
• Pietra N, Sarli L, Costi R: Role of follow-up in management of local recurrences of colorectal cancer: a prospective, randomized study. Dis Colon Rectum 1998 Sep; 41(9): 1127-33.[PubMed][Crossref]
• Chau I, Allen MJ, Cunningham D: The value of routine serum carcino-embryonic antigen measurement and computed tomography in the surveillance of patients after adjuvant chemotherapy for colorectal cancer (see comment). J Clin Oncol 2004; 22: 1420-29.[Crossref]
• Cubiella J, Gómez R, Sánchez E: Endoscopic follow-up of patients after curative surgery for colorectal cancer: results of a medical assistance protocol. Rev Esp Enferm Dig 2003 Apr; 95(4): 278-81, 273-77.[PubMed]
• Cuquerella J, Ortí E, Canelles P: Colonoscopic follow-up of patients undergoing curative resection of colorectal cancer" Gastroenterol Hepatol 2001 Nov; 24(9): 415-20.[PubMed][Crossref]
• McFall MR, Woods WG, Miles WF: Colonoscopic surveillance after curative colorectal resection: results of an empirical surveillance programme Colorectal Dis 2003 May; 5(3): 233-40.[PubMed]

Identifiers

DOI

10.2478/v10035-011-0048-y