Our experience with CEA in the management of colorectal cancer – a prospective study

Abstract

Introduction : In India, colorectal cancer is the 6th most prevalent cancer and population based time trend studies show a rising trend in its incidence. CEA is expressed in significant amounts post-natally by the carcinomas arising from large intestine. Currently, the most useful application of CEA is in the detection of liver metastasis from colorectal cancers and serial determination of CEA is recommended for detecting cancer spread to the liver. Aim: To assess the role of CEA in the management of colorectal cancer, and detection of early recurrence. Methods and Material: 30 patients with colorectal cancer admitted in Vydehi Institute of Medical Sciences & Research Centre during the period of November 2012 to April 2014 were included in a prospective study. Statistical analysis used: Descriptive statistics were calculated for all variables. Analysis was performed using the SPSS 14.0 statistical package. Results: Total patients included in the study was 30. The mean age at presentation was 48.66yrs. The most common site of malignancy was rectum (46.66%), and most of the patients presented in stage I. Pre-operatively CEA was raised in 22 cases. On postoperative follow-up, CEA was found to be elevated in 7 cases. 6 out of these cases had proven recurrence. One case was found to have peritoneal deposit in spite of CEA levels being normal. The sensitivity and specificity of using CEA as an indicator for recurrence were 85.71% and 95.65% respectively. Conclusions: Since colorectal cancer is associated with considerable morbidity and mortality, early diagnosis and management provide a chance for better survival. The use of CEA as an early indicator for recurrence has been evaluated in this study and can be used for the same. However, a larger size and longer duration of study is needed to effectively prove the same.