PREOPERATIVE CARCINOEMBRYONIC ANTIGEN IS RELATED TO TUMOR STAGE AND LONG-TERM SURVIVAL IN COLORECTAL-CANCER

Evidence as to the value of preoperative carcinoembryonic antigen (CEA ) in guiding treatment for patients with colorectal cancer is conflict ing. The aim of this prospective study was to investigate the value of preoperative CEA in predicting tumour factors of proven prognostic va lue and long-term survival in patients undergoing surgery for colorect al cancer, Preoperative serum CEA, tumour ploidy, stage and grade were ascertained in 277 patients undergoing colorectal cancer surgery. Thi s cohort of patients were followed up for a minimum of 5 years, or unt il death, in a dedicated colorectal clinic. Patients with an elevated CEA had a 5 year survival of 39%. This increased to 57% ii the CEA was normal (P = 0.001). The proportion of patients with a raised CEA incr eased with a more advanced tumour stage (P < 0.000001) and a poorly di fferentiated tumour grade (P < 0.005), Once stage had been controlled for, CEA was not a predictor of survival. No relationship between tumo ur ploidy and CEA was found. In conclusion, a raised preoperative seru m CEA is likely to be associated with advanced tumour stage and poor l ong-term survival, compared with patients with a normal value.