Intensive Risk-Adjusted Follow-up With the CEA, TPA, CA19.9, and CA72.4 Tumor Marker Panel and Abdominal Ultrasonography to Diagnose Operable Colorectal Cancer Recurrences (Articolo in rivista)

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  • Intensive Risk-Adjusted Follow-up With the CEA, TPA, CA19.9, and CA72.4 Tumor Marker Panel and Abdominal Ultrasonography to Diagnose Operable Colorectal Cancer Recurrences (Articolo in rivista) (literal)
Anno
  • 2010-01-01T00:00:00+01:00 (literal)
Alternative label
  • Andrea Nicolini, MD; Paola Ferrari, MD; Michael J. Duffy, MD; Alessandro Antonelli, MD;Giuseppe Rossi, BSc; Maria Rita Metelli, BSc; Franca Fulceri, BSc; Loretta Anselmi, MD; Massimo Conte, MD; Piero Berti, MD; Paolo Miccoli, MD (2010)
    Intensive Risk-Adjusted Follow-up With the CEA, TPA, CA19.9, and CA72.4 Tumor Marker Panel and Abdominal Ultrasonography to Diagnose Operable Colorectal Cancer Recurrences
    in Archives of surgery (Chicago, 1960)
    (literal)
Http://www.cnr.it/ontology/cnr/pubblicazioni.owl#autori
  • Andrea Nicolini, MD; Paola Ferrari, MD; Michael J. Duffy, MD; Alessandro Antonelli, MD;Giuseppe Rossi, BSc; Maria Rita Metelli, BSc; Franca Fulceri, BSc; Loretta Anselmi, MD; Massimo Conte, MD; Piero Berti, MD; Paolo Miccoli, MD (literal)
Pagina inizio
  • 1177 (literal)
Pagina fine
  • 1183 (literal)
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  • 145 (literal)
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  • 7 (literal)
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  • 12 (literal)
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  • ubMe (literal)
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  • Departments of Internal Medicine(Drs Nicolini, Ferrari, Antonelli and Anselmi), Experimental Pathology (Mss Metelli and Fulceri), and Surgery (Drs Conte, Berti and Miccoli), University of Pisa, Pisa, Italy; Department of Pathology and Laboratory Medicine (Dr Duffy), St Vincent University Hospital and Conway Institute, School of Medicine and Medical Science, University College, Dublin, Ireland; Unit of Epidemiology and Biostatistics, Institute of Clinical Phisiology, National Council of Research, Pisa (Mr Rossi); and Focus Group on Gastrointestinal Cancer, European Group on Tumor Markers (Drs Nicolini and Duffy). (literal)
Titolo
  • Intensive Risk-Adjusted Follow-up With the CEA, TPA, CA19.9, and CA72.4 Tumor Marker Panel and Abdominal Ultrasonography to Diagnose Operable Colorectal Cancer Recurrences (literal)
Abstract
  • Hypothesis: Intensive risk-adjusted follow-up leads to improved resectability of tumor recurrences and better overall survival among patients who have undergone surgery for colorectal cancer. Design: Long-term observational single-center study. Setting: University of Pisa, Pisa, Italy. Patients: One hundred eight disease-free patients who had undergone surgery for colorectal cancer were submitted to long-term follow-up with the serum CEA, TPA, CA19.9, and CA72.4 tumor marker (TM) panel and abdominal ultrasonography. Main Outcome Measures: Sensitivities and specificities of TMs, abdominal ultrasonography, and abdominal and chest computed tomography (CT); the median survival among patients operated on and those not operated on and the cumulative 5-year overall survival among the entire group. Results: Twenty-two patients with asymptomatic colorectal cancer recurred 32 times. The CEA, TPA, CA19.9, CA72.4, and TM panel sensitivities were 46.9%, 34.4%, 9.4%, 9.4%, and 81.0%, respectively, and the mean (SD) lead times before confirmation of recurrence were 4.3 (4.8), 4.1 (4.7), 8.3 (10.9), 5.0 (7.0), and 5.3 (5.8) months, respectively. Abdominal and chest CT sensitivities were 100.0%. Among 86 patients without recurrence, specificities of the TM panel and all panel markers were 100.0%, while specificities of abdominal ultrasonography, abdominal CT, and skeletal CT were 99.9%, 99.0%, and 100.0%, respectively. The median survival after first recurrence was 16 months (range, 3-48 months) for 8 patients with recurrence who did not undergo second-line surgery. Among 14 remaining patients who underwent metastasectomy, the median survival after first recurrence was 37 months (range, 12-187 months; P=.03). Among the entire group of 108 patients, the cumulative 5-year overall survival was 88.7%. Conclusions: Long-term intensive risk-adjusted monitoring using the CEA, TPA, CA19.9, and CA72.4TMpanel and abdominal ultrasonography allows early detection of most recurrences. Patients can then undergo radical metastasectomy, with potentially improved overall survival. (literal)
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