The significance of preoperative serum CEA levels for predicting clinical stage, prognosis and recurrence of colorectal cancer was investigated to obtain a source for informed consent in patients with colorectal cancer. Three hundred twenty nine patients who underwent surgery in our department was analyzed by the medical records from 1986 to 1990. 55.3% of these patients had normal CEA levels before surgery. All cases with preoperative serum CEA levels over 5.1 ng/ml had more advanced cancer. 77.0% of patients with preoperative serum CEA levels over 10.1 ng/ml had lymph node metastasis. Furthermore, 50.0% of patients with preoperative serum CEA levels over 20.0ng/ml had hepatic metastasis. Patients with elevated preoperative serum CEA levels had higher rates of recurrence and poor prognosis than those with normal serum CEA levels. CEA levels were elevated at recurrence in 75.0% of cases with elevated serum CEA levels before surgery. But CEA levels were within normal limit even at recurrence in 62.5% of cases with normal serum CEA levels before surgery. Thus, measuring serum CEA levels was not helpful for predicting recurrence of colorectal cancer in cases with normal serum CEA levels before surgery, but surveillance with diagnostic imaging was useful to detect recurrence in these cases.
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