The prognostic value of carcinoembryonic antigen in T1N1M0 and T2N1M0 non-small cell carcinoma of the lung

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• 作者：Ryuta Fukai ; Yukinori Sakao ; Motoki Sakuraba ; Shiaki Oh ; Kazu Shiomi ; Satoshi Sonobe ; Yuichi Saitoh ; Hideaki Miyamoto
• 关键词：Lung cancer ; Stage II ; N1 ; Carcinoembryonic antigen
• 刊名：European Journal of Cardio-Thoracic Surgery
• 出版年：2007
• 出版时间：September 2007
• 年：2007
• 卷：32
• 期：3
• 页码：440-444
• 全文大小：110 K

文摘

Objective: To evaluate the significance of preoperative clinicopathological factors, including serum carcinoembryonic antigen (CEA), as well as postoperative clinicopathological factors in T1-2N1M0 patients with non-small cell lung cancer who underwent curative pulmonary resection. Methods: Twenty T1N1M0 disease patients and 25 T2N1M0 patients underwent standard surgical procedures between September 1996 and December 2005, and were found to have non-small lung cancer. As prognostic factors, we retrospectively investigated age, sex, Brinkman index, histologic type, primary site, tumor diameter, clinical T factor, clinical N factor, pathological T factor, preoperative serum CEA levels, surgical procedure, visceral pleural involvement, and the status of lymph node involvement (level and number). Results: The overall 5-year survival rate of all patients was 59.6 % . In univariate analysis, survival was related to age (<70/≥70 years, p = 0.0079), site (peripheral/central, p = 0.043), and CEA level (<5.0/≥5.0 ng/ml, p = 0.0015). However, in multivariate analysis, CEA (<5.0/≥5.0 ng/ml) was the only independent prognostic factor; the 5-year survival of the patients with an elevated serum CEA level (≥5.0 ng/ml) was only 33.2 % compared to 79.9 % in patients with a lower serum CEA level (<5.0 ng/ml). Conclusions: An elevated serum CEA level (≥5.0 ng/ml) was an independent predictor of survival in pN1 patients except for T3 and T4 cases. Therefore, even in completely resected pN1 non-small cell lung cancer, patients with a high CEA level might be candidates for multimodal therapy.