Postsurgical surveillance for recurrence of UICC stage I colorectal carcinoma: is follow-up by CEA justified?

Hepatogastroenterology. 2005 Mar-Apr;52(62):444-9.

Abstract

Background/aims: 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.

Methodology: 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.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Carcinoembryonic Antigen / blood*
  • Carcinoma / blood
  • Carcinoma / pathology
  • Carcinoma / surgery*
  • Colorectal Neoplasms / blood
  • Colorectal Neoplasms / pathology
  • Colorectal Neoplasms / surgery*
  • Female
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Neoplasm Recurrence, Local / blood*
  • Neoplasm Recurrence, Local / diagnosis*
  • Neoplasm Recurrence, Local / epidemiology
  • Neoplasm Recurrence, Local / surgery
  • Neoplasm Staging
  • Population Surveillance*
  • Postoperative Period
  • Retrospective Studies
  • Survival Analysis

Substances

  • Carcinoembryonic Antigen