Clinicopathological Study of Postoperative Recurrence of Colorectal Cancer -Diagnostic Usefulness of Carcino-Embryonic Antigen-

Masayoshi Sakane, Yoshiki Horita, Michio Kato, Toshimasa Yamaguchi, Satoru Okumoto, Katsuya Kuroda, Yoichi Saitoh

First Department of Surgery, Kobe University School of Medicine

The clinicopathological charasteristics and the methods for early detection of recurrence of colorectal cancer were studied in 41 patients (27.9%) who had a recurrence among 147 patients who could be followed up for at least 2 years after curative resection of the primary lesion. Of the 41 patients with recurrence, 18 (43.9%) had colon cancer and 23 (56.1%) had rectal cancer. Distant blood-borne recurrence was observed in 28 (68.3%) and was frequently associated with a depth of s (a₂) or above, n (+) or ly (+), and stage III or IV. Local recurrence was observed in 14 patients (34.2%) and was frequently associated with moderately differentiated adenocarcinoma, n (+) or ly (+), and stage III or IV. Blood-borne and local recurrences were detected within 2 years in 89.3% and 85.7%, respectively. Carcinoembryonic antigen (CEA) slope analysis showed higher slope values in patients with blood-borne than local recurrence. The CEA level was increased 3.28 months (mean) before detection of the recurrent lesion by imaging techniques, and the CEA level is considered to be the most useful for diagnosis of recurrence. Clinical findings such as palpation of a mass were also of diagnostic value in rectal cancer. The 3-year-survival rate for the 41 patients with recurrence was low, 20.3%, and there was no difference in outcome between blood-borne and local recurrence.

Key words
colorectal cancer, postoperative recurrence of colorectal cancer, diagnosis of recurrence of colorectal cencer, risk factor of recurrence of colorectal cancer

Reprint requests
Masayoshi Sakane First Department of Surgery, Kobe University School of Medicine
7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650 JAPAN

Accepted
November 19, 1990

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