A 62-year-old man undergoes anterior resection for a Duke's C adenocarcinoma of the sigmoid colon with clear histological margins. Postoperatively he receives adjuvant FOLFOX chemotherapy. Which tumour marker should be serially measured during follow-up to detect recurrence?

• A CA 19-9
• B Alpha-fetoprotein
• C CA 125
• D Carcinoembryonic antigen (CEA) ✓

Explanation

CEA is the standard marker for monitoring colorectal cancer after curative resection; a rising serial CEA precedes radiographic recurrence and prompts imaging. CA 19-9 is the marker of pancreaticobiliary malignancy, not colorectal cancer, and its use here would be the tempting error. CA 125 tracks epithelial ovarian cancer and AFP hepatocellular carcinoma and germ cell tumours. Preoperative CEA level also carries independent prognostic value in colorectal cancer.

Reference: Bailey and Love's Short Practice of Surgery, 28th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.