Background: Endometrial carcinoma is the most frequent genital neoplasm in women with excellent therapeutic outcome in early stage I. During the follow-up of these patients after curative resection and radiotherapy the role of CEA for the detection of recurrent disease was determined retrospectively.
Patients and methods: From 1986 to 1995 a total of 128 patients with stage I endometrial carcinoma were treated in our clinic with postoperative radiotherapy. CEA serum levels were measured preoperatively and at the regular follow-up sessions for all patients. Only 10 patients suffered from recurrent disease during the median observation period of 62.1 months.
Results: Preoperatively 8 out of 128 patients (6.3%) had a moderate elevation of CEA level at 5.1 to 7.74 ng/ml, which decreased in 5 cases below the cut-off level of 5.0 ng/ml after surgery. No patient with preoperatively increased CEA level had relapsed during the follow-up, but 3 other patients had a significant increase of CEA: one patient with an extended pelvic recurrence and one with systemic pulmonary relapse. The third patient had a metachronous breast cancer with additional increase of CA 125 serum level, but no evidence of recurrent disease from endometrial carcinoma.
Conclusion: Our results indicate that only 6.3% of all patients with stage I endometrial carcinoma and 20% of the patients with recurrent disease could benefit from routine follow-up measurement of the CEA serum level. However, in none of these reported cases had the increased CEA level influenced the therapeutic decision. Therefore, the routine measurement of CEA in asymptomatic follow-up patients is not recommended.