Postoperative Serum CEA Level is a More Significant Prognostic Factor than Post/Preoperative Serum CEA Ratio in Non-small Cell Cancer Patients.

Masaki Tomita,Kunihide Nakamura,Takanori Ayabe,Eiichi Chosa

doi:10.7314/apjcp.2015.16.17.7809

Abstract

In non-small cell lung cancer (NSCLC) patients with preoperative high serum carcinoembryonic antigen (CEA) level, patients with a persistently high serum CEA level after surgery have been reported to have a poor prognosis. In addition, in other cancers, the post/preoperative serum CEA ratio has been reported as a useful parameter. We enrolled 123 NSCLC patients with preoperative high CEA levels (≥ 5 ng/mL) who underwent curative surgery between 2004 and 2011. Prognostic significance of postoperative serum CEA level and the CEA ratio was examined. The 5-year survival of patients with persistently high serum CEA level after surgery was poor. On the other hand, patients with normal postoperative serum CEA levels had significant favorable prognosis. The patients with CEA ratio>1 had poor prognosis, however the number was only 7 (5.7%). The 5-year survival rates of patients with other subgroup based on the CEA ratio (0.5 ≥ CEA ratio and 0.5 ≤ CEA ratio ≤ 1) was similar. Multivariate analysis revealed prognostic significance for the postoperative serum CEA level but not the CEA ratio. For NSCLC patients with preoperative high serum CEA level, their postoperative serum CEA levels is a more significant prognostic factor than the post/preoperative serum CEA ratio.

Highlights

Carcinoembryonic antigen (CEA) is the most widely used tumor marker in patients with non-small cell lung cancer (NSCLC) (Grunnet et al, 2012)
Several studies revealed the prognostic significance of preoperative serum carcinoembryonic antigen (CEA) level (Sawabata et al, 2002; Okada et al, 2004; Tomita et al, 2004; Grunnet et al, 2012)
Sawabata et al assessed 297 patients with clinical stage I NSCLC and found that serum CEA level is a useful predictor of survival of patients with stage I NSCLC (Sawabata et al, 2002)

Summary

Introduction

Carcinoembryonic antigen (CEA) is the most widely used tumor marker in patients with non-small cell lung cancer (NSCLC) (Grunnet et al, 2012). Several studies have suggested that preoperative serum CEA is an independent prognostic factor for NSCLC (Sawabata et al, 2002; Okada et al, 2004; Tomita et al, 2004; Grunnet et al, 2012). In non-small cell lung cancer (NSCLC) patients with preoperative high serum carcinoembryonic antigen (CEA) level, patients with a persistently high serum CEA level after surgery have been reported to have a poor prognosis. Results: The 5-year survival of patients with persistently high serum CEA level after surgery was poor. Conclusions: For NSCLC patients with preoperative high serum CEA level, their postoperative serum CEA levels is a more significant prognostic factor than the post/preoperative serum CEA ratio

Methods

Results

Conclusion