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In a retrospective study the postoperative time courses of CEA in colorectal cancer patients with recurrent disease were analysed. In 87/114 cases with increasing concentrations of circulating CEA under close follow-up a linear relationship between log CEA and time could be established during disease recurrence. The individual doubling times of the serum CEA concentration in the log CEA period were calculated and found to cover distinct ranges dependent on the diagnosis of disease recurrence. The CEA doubling times concomitant with local recurrence or second primary carcinomas ranged from 142 to 868 days, visceral metastasis other than liver metastasis from 47 to 231 days and liver metastasis from 10 to 102 days. Patients with bone metastases exhibited CEA doubling times of 54-60 days and a patient with brain metastasis had a CEA doubling time of 598 days. The CEA doubling times of patients with liver metastasis and no further treatment, correlated well with the time of survival after the initial CEA increase of the log CEA phase (r = 0.870, n = 33). The mean survival expressed in multiples of the individual CEA doubling times was 7.0 +/- 1.8. Patients with liver metastasis who underwent various treatments of recurrent disease had a distinctly longer mean survival of 17.4 +/- 9.4 CEA doubling times (P less than 0.001). CEA doubling times can be used as a potential method to assess the efficacy of various treatments.

Doubling time of circulating cea and its relation to survival of patients with recurrent colorectal cancer