Tumor markers in long-term follow-up of patients with carcinomas of the head and neck

The role of tumor markers in the long-term follow-up of patients with head and neck tumors is highly controversial. The following paper presents a retrospective analysis of the time course of the markers SCC, CEA and NSE in 100 assessable patients out of a total of 142 patients with squamous cell carcinoma of the head and neck. The sensitivities of the respective substances on their own were very low (SCC 41.2%, CEA 32.3%, NSE 67.6%). A sensitivity of 91.2% was only obtained by combining the markers SCC and NSE. However, the specificity of this combination is fairly low (60.9%). The importance of NSE resides in its high degree of sensitivity in patients with remote metastases. The additional determination of CEA is of no added diagnostic benefit. A rise in tumor markers was the first sign of progressive disease in 32.4% of patients with recurrent disease. No therapeutic benefit can at present be derived from the time gained. On balance, determination of the named tumor marker combination is a reliable, non-invasive, clinically enhancing aid in the long-term follow-up of patients with carcinomas of the head and neck.