182P - Serum CEA directed PET-CECT scan strategy for followup of colorectal cancer post curative therapy

Date 17 December 2016
Event ESMO Asia 2016 Congress
Session Poster lunch
Topics Biomarkers
Colon and Rectal Cancer
Rectal Cancer
Staging procedures (clinical staging)
Presenter Karthik Chandra Vallam
Citation Annals of Oncology (2016) 27 (suppl_9): ix53-ix67. 10.1093/annonc/mdw581
Authors K.C. Vallam1, G. Channabasavaiah2, A. Agarwal3, V. Rangarajann3, V. Ostwal4, R. Engineer5, A. Saklani6
  • 1Surgical Oncology, Mahatmagandhi Cancer Hospital and Research Institute, 530017 - Visakhapatnam/IN
  • 2Surgical Oncology, Caritas Cancer Institute Kottayam, 688630 - Kottayam/IN
  • 3Nuclear Medicine, Tata Memorial Hospital Centre, 400012 - Mumbai/IN
  • 4Medical Oncology, Tata Memorial Hospital Centre, 400012 - Mumbai/IN
  • 5Radiation Oncology, Tata Memorial Hospital Centre, 400012 - Mumbai/IN
  • 6Surgical Oncology, Tata Memorial Hospital Centre, 400012 - Mumbai/IN



As per existing guidelines, during the follow-up of surgically resected colorectal cancer, PET-CT is indicated for asymptomatic elevation of CEA>5ng/ml and no obvious site of recurrence on clinical examination and basic imaging. As an instituitional policy, PET-CECT scan was being performed at our institute whenever 1)CEA levels rose above 5 ng/ml and 2)whenever there was doubling of CEA value (even if CEA was


We retrospectively analysed all cases where a PET-CT scan was performed for elevated CEA during the post treatment period after complete resection of the primary tumour with adjuvant therapy. Study period was from January 1,2013 to July 31, 2015.


Among 104 patients who underwent PET/CT scan for rising CEA values, 59.6% patients were found to have recurrent disease. At CEA level < 5ng/ml, 5.1-10 ng/ml, 10.1-15 ng/ml, 15.1-50 ng/ml and >50 ng/ml, disease recurred in 10%, 45%,70%,94% and 100% of patients, respectively. Sensitivity, specificity, positive predictive value and negative predictive value of PET/CT scan were 92.7%,95.2%,96.2% and 90.9%, respectively.CEA elevation during follow-up was indicative of recurrence in 68% of secretors and 45% of non-secretors (based on baseline CEA status).


In the setting of rising CEA levels during follow-up of colorectal cancer patients, PET/CT scan is a valuable tool to detect recurrence, irrespective of the baseline CEA secretor status.

Clinical trial indentification

Not applicable

Legal entity responsible for the study

Karthik Chandra




All authors have declared no conflicts of interest.