The prognostic information from carcinoembryonic antigen was evaluated in bacteria-free urines of patients with bladder carcinoma. Patients with elevated ( a 3 0 ng/ml) U-CEA had a poorer relative and symptom-free survival than patients with initial U-CEA below 30 ng/ml. Patients in whom U-CEA decreased from before to after radiation treatment had a better survival rate than patients with increasing U-CEA. These findings were most significant in cases with large (T3 + T4) tumors or with tumors of a lower differentiation (G3). U-CEA appeared to be an independent variable for prognostic evaluation of survival, since these differences were also true within the subgroups of known variables such as classes or grades. All but one of the patients, in whom short-term local control was obtained, had a posttreatment U-CEA below 50 ng/ml. In oncology units, where the more malignant bladder tumors are treated, U-CEA determinations may indicate which patients require intensified monitoring or treatment.
Cancer 50:139-145, 1982.
ERUM CARCINOEMBRYONIC antigen (S-CEA) has S proved useful in the prognostic evaluation and monitoring of patients with colorectal carcinoma.' CEA is also measurable in the urine (U-CEA) and several a ~t h o r s ~-~ have found an increased content in the presence of bladder carcinoma.
A serious drawback to the use of U-CEA for monitoring along the lines adopted with S-CEA is that increases are also elicited by urinary infection^.'.^.^ To analyse the potential use of U-CEA in patients with bladder carcinoma, determinations were made in urines free of bacterial infections and obtained serially from patients receiving radiotherapy." These investigations showed that U-CEA decreased after treatment in most cases with successful therapy. Also, high or increasing U-CEA levels were seen when the patients developed a local recurrence. The latter information seemed to apply only to relatively advanced tumors.