Mentges B
Klinik und Poliklinik für Allgemein- und Abdominalchirurgie der Chirurgischen Universitätsklinik Mainz.
Langenbecks Arch Chir. 1988;373(4):227-34. doi: 10.1007/BF01261814.
A rising CEA level did not indicate an early tumour recurrence in the follow-up of 660 patients with curative surgery because of colorectal carcinoma. In case of rectal carcinoma the first rise of the tumour marker preceded diagnosis of recurrence by other means 7.9 months on an average, in case of colonic carcinoma 5.1 months. The long-term survival after secondary procedure was 17.5% for patients with normal CEA value at time of reoperation and surmounted life expectancy of patients with rising tumour-marker level significantly (5.9%). The worst prognosis was found for the collective with rising CEA before diagnosis of relapse by other means, none of whom was saved by reoperation. The resectability rate of metastases was higher than that of local recurrences with nearly identical survival for both groups. Because of the long CEA lead times advances in therapy by second-look procedures are to be expected mainly for patients with pelvic recurrences after abdominoperineal extirpation.
在660例因结直肠癌接受根治性手术的患者随访中,癌胚抗原(CEA)水平升高并不表明肿瘤早期复发。对于直肠癌患者,肿瘤标志物首次升高平均比通过其他手段诊断复发提前7.9个月;对于结肠癌患者,提前5.1个月。二次手术后,再次手术时CEA值正常的患者长期生存率为17.5%,显著高于肿瘤标志物水平升高的患者(5.9%)。在通过其他手段诊断复发之前CEA就升高的患者群体预后最差,他们中无一例通过再次手术挽救生命。转移灶的可切除率高于局部复发灶,两组生存率相近。由于CEA出现升高的时间较长,预计主要对经腹会阴联合切除术后盆腔复发的患者通过二次探查手术进行治疗。