The use of serial CEA determinations to predict recurrence of colon cancer and when to do a second‐look operation

Abstract

The concept of second‐look surgery was introduced by Wangensteen 25 years ago, and 17% of patients were reported to be converted to a cancer‐free state. Instead of an arbitrary time interval for reoperation, serial CEA values were used as the indicator of colon cancer recurrence and second‐look operation. Twenty‐two retrospective and 18 prospective patients were evaluable. There was no operative mortality. The CEA Nomogram was used to determine whether the CEA change was significant. All patient‐samples were analyzed in duplicate, stored, and compared with the most recent sample; therefore, each patient served as his own control. The prospective results emphasize the importance of minimizing the time delay between a significant change in CEA values and reoperation. Equally important are the frequency of serial determinations (every one or two months), a thorough understanding of the limitations of the CEA radioimmunoassay, and the clinical condition of the patient. Copyright © 1978 American Cancer Society