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Ann Thorac Surg 2002;74:174-179
© 2002 The Society of Thoracic Surgeons
a Division of Surgery, Toneyama National Hospital, Toyonaka, Osaka, Japan
c Division of Clinical Pathology, Toneyama National Hospital, Toyonaka, Osaka, Japan
b Division of General Thoracic Surgery, Department of Surgery (E-1), Osaka University Graduate School of Medicine, Osaka, Japan
* Address reprint requests to Dr Sawabata, Division of Surgery, Toneyama National Hospital, 5-1-1 Toneyama, Toyonaka, Osaka 560-8552, Japan
e-mail: nori{at}toneyama.hosp.go.jp
Presented at the Poster Session of the Thirty-eighth Annual Meeting of The Society of Thoracic Surgeons, Fort Lauderdale, FL, Jan 28–30, 2002.
Background. There is little general agreement concerning the effectiveness of serum carcinoembryonic antigen (CEA) as a prognostic indicator for non-small cell lung cancer (NSCLC) in clinical stage I patients. We conducted a retrospective study to investigate the relationship between serum CEA level and survival.
Methods. We assessed 297 consecutive patients with clinical stage I NSCLC who underwent surgical resection at Toneyama National Hospital from 1985 to 1998. Serum CEA levels were measured with an enzyme-linked immunosorbent assay kit with the upper limit of normal defined as 7.0 ng/mL based on the 95% specificity level for benign lung disease, in our hospital.
Results. There were 56 (19%) patients with serum CEA greater than 7.0 ng/mL. The high CEA group had a median survival time of 50 months and a 5-year survival rate of 49% compared with a 5-year survival rate of 72% (p < 0.0001) for the normal CEA group (n = 241). Patients with postoperatively high CEA levels (n = 15) had the worse prognosis (median survival time 35 months, and 5-year survival 18%) compared with patients whose levels returned to normal (n = 41, median survival time 8 8 months, and 5-year survival 68%; p = 0.01). These differences were also observed in patients with pathologic stage I or II tumors but not in those with pathologic stage III or IV tumors.
Conclusions. Serum CEA level is a useful predictor of survival for patients with clinical stage I NSCLC, and a persistently high CEA level after surgery is an especially strong indicator of a very poor prognosis.
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