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Ann Thorac Surg 2007;83:419-424
© 2007 The Society of Thoracic Surgeons

Original Articles: General Thoracic

Preoperative Serum Carcinoembryonic Antigen Level is a Prognostic Factor in Women With Early Non–Small-Cell Lung Cancer

Wen-Hu Hsu, MDa,*, Chien-Sheng Huang, MDa, Han-Shui Hsu, MDa, Wen-Jen Huang, MDb, Hui-Chen Lee, BSc, Biing-Shiun Huang, MD, PhDa, Min-Hsiung Huang, MDa

a Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan
c Division of Experimental Surgery, Department of Surgery, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan
b Division of Thoracic Surgery, Department of Surgery, Mackay Memorial Hospital, Taipei, Taiwan

Accepted for publication July 26, 2006.

* Address correspondence to Dr Wen-Hu Hsu, Division of Thoracic Surgery, Department of Surgery, Taipei Veterans General Hospital, and National Yang-Ming University School of Medicine, No 201, Section 2, Shih-Pai Rd, Taipei, Taiwan. (Email: whhsu{at}vghtpe.gov.tw).

BACKGROUND: Carcinoembryonic antigen (CEA) is one of the markers evaluated in patients with non–small cell lung cancer (NSCLC). The significance of the preoperative serum CEA level in female patients with NSCLC is seldom discussed. In this study, we conducted a retrospective review to investigate the prognostic significance of the preoperative CEA level in female patients with stage I NSCLC.

METHODS: In this study, we looked at 163 female patients with stage I NSCLC. Patient charts were reviewed to collect patient data, including the age of the patient, tumor location, tumor size, visceral pleural invasion, the stage of disease, and the preoperative serum CEA level. The cutoff value of serum CEA level was 6.0 ng/mL. The significance of preoperative CEA level in the prognosis of female patients with stage I NSCLC was evaluated.

RESULTS: Among the 163 female patients with stage I NSCLC, 47 patients (28.8%) had abnormal preoperative serum CEA level (>6 ng/mL). Diagnosis of adenocarcinoma and bronchoalveolar carcinoma accounted for 83.4% of these 163 female patients. In-hospital mortality was encountered in 1 patient. Univariate analysis of survival in the other 162 female patients with stage I NSCLC showed that age, stage, tumor size, and preoperative CEA level were prognostic factors. Visceral pleural invasion had no impact on the prognosis of these patients. Multivariate analysis revealed that tumor size and preoperative CEA level were independent prognostic factors in female patients with stage I NSCLC.

CONCLUSIONS: Preoperative serum CEA level and tumor size are independent prognostic factors in female patients with stage I NSCLC. In contrast, visceral pleural invasion was not associated with the prognosis. Importantly, these results suggest that female patients with abnormally high preoperative CEA level and tumor size larger than 3 cm may need a thorough preoperative evaluation and careful postoperative follow-up to rule out occult metastasis of early NSCLC.


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Invited commentary
Joe B. Putnam, Jr
Ann. Thorac. Surg. 2007 83: 424. [Extract] [Full Text] [PDF]



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Invited commentary
Ann. Thorac. Surg., February 1, 2007; 83(2): 424 - 424.
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