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Cancers 2011, 3(2), 2302-2315; doi:10.3390/cancers3022302
Review

The Role of High Frequency Dynamic Threshold (HiDT) Serum Carcinoembryonic Antigen (CEA) Measurements in Colorectal Cancer Surveillance: A (Revisited) Hypothesis Paper

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Received: 25 January 2011; in revised form: 22 April 2011 / Accepted: 4 May 2011 / Published: 11 May 2011
(This article belongs to the Special Issue Prognostic and Predictive Factors in Colorectal Cancer)
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Abstract: Following curative treatment for colorectal cancer (CRC), 30% to 50% of patients will develop recurrent disease. For CRC there are several lines of evidence supporting the hypothesis that early detection of metachronous disease offers a second opportunity for cure. This paper revisits the potential role of serum carcinoembryonic antigen (CEA) in follow-up. A comprehensive review of the literature (1978–2008) demonstrates that the initial promise of serum CEA as an effective surveillance tool has been tarnished through perpetuation of poorly designed studies. Specific limitations included: testing CEA as only an ‘add-on’ diagnostic tool; lack of standardization of threshold values; use of static thresholds; too low measurement frequency. Major changes in localizing imaging techniques and treatment of metastatic CRC further cause a decrease of clinical applicability of past trial outcomes. In 1982, Staab hypothesized that the optimal benefit of serum CEA as a surveillance tool is through high-frequency triage using a dynamic threshold (HiDT). Evidence supporting this hypothesis was found in the biochemical characteristics of serum CEA and retrospective studies showing the superior predictive value of a dynamic threshold. A multi-centred randomized phase III study optimizing the usage of HiDT against resectability of recurrent disease is commencing recruitment in the Netherlands.
Keywords: carcinoembryonic antigen; colorectal cancer; follow-up; recurrent disease; metastases carcinoembryonic antigen; colorectal cancer; follow-up; recurrent disease; metastases
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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MDPI and ACS Style

Grossmann, I.; Verberne, C.; De Bock, G.; Havenga, K.; Kema, I.; Klaase, J.; Renehan, A.; Wiggers, T. The Role of High Frequency Dynamic Threshold (HiDT) Serum Carcinoembryonic Antigen (CEA) Measurements in Colorectal Cancer Surveillance: A (Revisited) Hypothesis Paper. Cancers 2011, 3, 2302-2315.

AMA Style

Grossmann I, Verberne C, De Bock G, Havenga K, Kema I, Klaase J, Renehan A, Wiggers T. The Role of High Frequency Dynamic Threshold (HiDT) Serum Carcinoembryonic Antigen (CEA) Measurements in Colorectal Cancer Surveillance: A (Revisited) Hypothesis Paper. Cancers. 2011; 3(2):2302-2315.

Chicago/Turabian Style

Grossmann, Irene; Verberne, Charlotte; De Bock, Geertruida; Havenga, Klaas; Kema, Ido; Klaase, Joost; Renehan, Andrew; Wiggers, Theo. 2011. "The Role of High Frequency Dynamic Threshold (HiDT) Serum Carcinoembryonic Antigen (CEA) Measurements in Colorectal Cancer Surveillance: A (Revisited) Hypothesis Paper." Cancers 3, no. 2: 2302-2315.



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