Clinical Chemistry -- eLetters for Duffy, 47 (4) 624-630

QUICK SEARCH:

	Author:		Keyword(s):
Year:		Vol:		Page:

Electronic Letters to:

Minireview:
Michael J. Duffy
Carcinoembryonic Antigen as a Marker for Colorectal Cancer: Is It Clinically Useful?
Clin Chem 2001; 47: 624-630 [Abstract] [Full text] [PDF]

Electronic letters published:

CEA should be measured in all colorectalcancer patients participating in clinical trials.: Joseph WATINE (27 April 2001)

CEA should be measured in all colorectalcancer patients participating in clinical trials. 27 April 2001

Joseph WATINE,
Eur Clin Chem
Hôpital de Rodez, France
Send letter to journal:
Re: CEA should be measured in all colorectalcancer patients participating in clinical trials.

j.watine.j{at}ch-rodez.fr Joseph WATINE

In a review article published in the April 2001 issue of Clin Chem, M. J. Duffy [1] concluded that “in the future, preoperative concentrations of carcinoembryonic antigen (CEA) may be included with the standard staging procedures for assessing prognosis”.
M. J. Duffy thus implicitly acknowledge that prognostic variables that are independent from each other are necessary to better design clinical trials. Indeed, the superiority of a given regimen over another one can hardly be affirmed if the prognostic profiles of the subgroups of patients who participate in clinical trials cannot be compared [2].
The numerous studies, and systematic reviews that have demonstrated the independent pre-teatment prognostic value of CEA, or other laboratory variables such as alkaline phosphatase (ALP) concentrations in colorectal cancer patients [1, 3, 4], would therefore support the recommendation that at least CEA and ALP concentrations should be systematically measured in colorectal cancer patients who participate in clinical trials. And, as already stressed elsewhere, not only analytical methods but also preanalytical ones should be indicated when these clinical trials are published – a basic principle of good science [3, 4].
Can we hope that our present comments will make it possible for these practical recommendations to be taken into account in future clinical trials?
Joseph Watine, associate member of the IFCC-LM C-EBLM (IFCC-LM C- EBLM, Committee on Evidence-Based Laboratory Medicine of the International Federation of Clinical Chemistry and Laboratory Medicine).
References
1) Duffy MJ. Carcinoembryonic antigen as a marker for colorectal cancer: is it clinically useful? Clin Chem 2001;47:624-30.
2) Fielding LP, Fenoglio-Preiser CM, Freedman LS. The future of prognostic factors in outcome prediction for patients with cancer. Cancer 1992;70:2367-7.
3) Watine J, Friedberg B. Preoperative Carcinoembryonic Antigen Level as an Independent Prognostic Factor in Colorectal Cancer. Further Comments. Jpn J Clin Oncol 2000;30:522-3.
4) Watine J, Miédougé M, Friedberg B. CEA as an independent prognostic factor of recurrence and survival in patients resected for colorectal liver metastases. A systematic review. Dis Colon Rectum 2001; in press.