Carcinoembryonic antigen assessment during the perioperative period in patients with colorectal cancer in Poland

Abstract

Introduction. Carcinoembryonic antigen (CEA) concentration is often elevated during the course of colorectal cancer. Assessment of the CEA level in this group of patients is recommended pre- and post-surgery, during systemic therapy, and further follow-up. A high preoperative level of CEA is a negative prognostic factor. The aim of the study was to determine the prevalence of CEA evaluation in the perioperative diagnostics in patients with colorectal cancer in Poland.

Materials and methods. The analysis included 620 patients with stage III colorectal cancer, who underwent radical surgery in five Polish oncological centres during 2000–2014. The analysis of the clinical practice concerning the determination of CEA was based on the available medical records involving the pre- and post-operative period.

Results. The determination of the CEA level before the surgery was performed in only 200 patients (32%), and in 528 patients (85%) following resection and before starting the adjuvant systemic chemotherapy. In 74% of patients the preoperative CEA level exceeded 5 ng/mL (median 10.5 ng/mL; standard deviation 4.4–22.5). After the surgical procedure in more than 85% of patients the CEA level was within to the recommended normal value of 5 mg/mL (median 1.9; standard deviation 1.1–3.4).

Conclusions. Preoperative CEA level is scarcely determined in patients with colorectal cancer in Polish centres, which may impede further monitoring of the disease course. These results suggest the need for better adherence to the recommendations concerning the pre- and postoperative diagnostics in this group of patients.