Summary
254 patients were operated for rectal carcinoma in the period from 1980 to 1986. The number of curative procedures, recurrence rate and 5-year-survival rate were dependent on the preoperative CEA levels, which correlated with the tumour stage. Even within tumour stages with enough cases for statistical evaluation the CEA could be established as an independent prognostical variable. Within stage pT2N0M0 recurrence rate for patients with preoperative CEA level below 5 ng/ml was 29% compared to 64% in patients with higher serum levels. Median survival time for the two groups were 65 and 35 months, respectively. In stage of lymph node involvement median survival times of 46 and 25 months were observed for the groups with CEA levels above and below 5 ng/ml. The pattern of recurrence within the two stages seemed to be unaffected by the preoperative CEA level. Patients with preoperative elevated CEA represent a risk group with need of consistent postoperative follow-up and CEA controls.
Zusammenfassung
Im Zeitraum von 1980 bis Ende 1986 wurden 254 Patienten an einem Rektumkarzinom operiert. Die Radikalität der Operation, Rezidiv- und 5-Jahres-Üebensrate erwiesen sich als abhägig von der Höhe des präoperativen CEA. Die Höhe des Tumormarkerspiegels korrelierte mit dem Tumorstadium. Auch innerhalb der Tumorstadien mit ausreichender Fallzahl erwies sich das CEA als unabhängige prognostische Variable. Im Stadium pT2N0M0 betrug die Rezidivrate für kurativ operierte Patienten mit präoperativem CEA unter 5 ng/ml 29% im Vergleich zu 64% im Kollektiv mit einem Markerspiegel über 5 ng/ml. Die entsprechenden medianen Oberlebenszeiten lagen bei 65 resp. 35 Monaten. Bei Vorliegen von Lymphknotenmetastasen betrug die mediane Überlebenszeit für Patienten mit CEA-Spiegel unter 5 ng 46 Monate im Vergleich zu 25 Monaten bei der Gruppe mit höheren Werten. Ein Einfluß des CEA auf das Rezidivmuster innerhalb der beiden Tumorstadien ließ sich nicht erkennen. Patienten mit pröperativ erhöhtem CEA stellen eine Risikogruppe dar, die der postoperativen Nachsorge und konsequenter CEA-Kontrollen bedürfen.
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Mentges, B., Brückner, R. & Weiss, C. Die bedeutung des präoperativen CEA-Wertes für die prognose des rektumkarzinoms. Langenbecks Arch Chiv 375, 106–111 (1990). https://doi.org/10.1007/BF00713395
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DOI: https://doi.org/10.1007/BF00713395