Trial reportBMJ open2014
The CEA Second-Look Trial: a randomised controlled trial of carcinoembryonic antigen prompted reoperation for recurrent colorectal cancer.
Trial report in BMJ open, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 papers, 5 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
26 citing papers in PubMed, 5 syntheses or guidelines pooled it, 63 citations in OpenAlex.
- Follow-up strategies for patients treated for non-metastatic colorectal cancer.The Cochrane database of systematic reviews · 2019Pooled it
- Pooled it
- Follow-up strategies for patients treated for non-metastatic colorectal cancer.The Cochrane database of systematic reviews · 2016Pooled it
- Meta-analysis of colorectal cancer follow-up after potentially curative resection.The British journal of surgery · 2016Pooled it
- Blood CEA levels for detecting recurrent colorectal cancer.The Cochrane database of systematic reviews · 2015Pooled it
- Adjuvant-containing control arms in pivotal quadrivalent human papillomavirus vaccine trials: restoration of previously unpublished methodology.BMJ evidence-based medicine · 2020Trial
- Pulmonary Metastasectomy in Colorectal Cancer: updated analysis of 93 randomized patients - control survival is much better than previously assumed.Colorectal disease : the official journal of the Association of Coloproctology of Great Britain and Ireland · 2020Trial
- Restoring Study 329: efficacy and harms of paroxetine and imipramine in treatment of major depression in adolescence.BMJ (Clinical research ed.) · 2015Trial
- Clinical utility of the carcinoembryonic antigen level in patients with stage III colon cancer after surgery and adjuvant chemotherapy.Surgery today · 2024Article
- Intensive follow-upWorld journal of gastrointestinal oncology · 2023Article
- Circulating tumour DNA in colorectal cancer management.The British journal of surgery · 2023Article
- Surveillance strategies following curative resection and non-operative approach of rectal cancer: How and how long? Review of current recommendations.World journal of gastrointestinal surgery · 2023Review
- Pulmonary metastasectomy: limits to credibility.Journal of thoracic disease · 2021Review
- The Combination Therapy of Fluorouracil and Oxaliplatin Suppress the Progression of Colon Cancer Through miR-183-5p/SOCS3 Axis and Downregulating PD-L1.Cancer management and research · 2021Article
- Markers of metastatic colorectal cancer.Przeglad gastroenterologiczny · 2020Review
- A Review of the Role of Carcinoembryonic Antigen in Clinical Practice.Annals of coloproctology · 2019Review
- Role of surveillance imaging and endoscopy in colorectal cancer follow-up: Quality over quantity?World journal of gastroenterology · 2019Review
- Cytoreduction for colorectal metastases: liver, lung, peritoneum, lymph nodes, bone, brain. When does it palliate, prolong survival, and potentially cure?Current problems in surgery · 2018Review
- Metastasectomy for colorectal cancer: are there clothes on the emperor?Journal of the Royal Society of Medicine · 2017Article
- Surveillance after curative treatment for colorectal cancer.Nature reviews. Clinical oncology · 2017Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveIn patients who have undergone a potentially curative resection of colorectal cancer, does a 'second-look' operation to resect recurrence, prompted by monthly monitoring of carcinoembryonic antigen, confer a survival benefit?
designA randomised controlled trial recruiting patients from 1982 to 1993 was recovered under the Restoring Invisible and Abandoned Trials (RIAT) initiative.
setting58 hospitals in the UK.
participantsFrom 1982 to 1993, 1447 patients were enrolled. Of these 216 met the criteria for carcinoembryonic antigen (CEA) elevation and were randomised to 'Aggressive' or 'Conventional' arms.
interventions'Second-look' surgery with intention to remove any recurrence discovered. PRIMARY OUTCOME MEASURE: Survival.
resultsBy February 1993, 91/108 patients had died in the 'Aggressive arm' and 88/108 in the 'Conventional' arm (relative risk=1.16, 95% CI 0.87 to 1.37). By 2011 a further 25 randomised patients had died. Kaplan-Meier analysis showed no difference in long-term survival.
conclusionsThe trial was closed in 1993 following a recommendation from the Data Monitoring Committee that it was highly unlikely that any survival advantage would be demonstrated for CEA prompted second-look surgery. This conclusion was confirmed by repeat analysis of survival times after 20 years. TRIAL REGISTRATION NUMBER: ISRCTN76694943.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.