Optimal predictive value of preoperative serum carcinoembryonic antigen for surgical outcomes in stage I non-small cell lung cancer: Differences according to histology and smoking status

Background The cutoff value of preoperative serum carcinoembryonic antigen (CEA) levels has not been investigated using appropriate subgroup analyses for non‐small cell lung carcinoma (NSCLC). This study was undertaken to determine whether the most predictive preoperative CEA level for risk of recur...

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Bibliographic Details
Published in:Journal of surgical oncology 2013-05, Vol.107 (6), p.619-624
Main Authors: Kato, Tatsuya, Ishikawa, Keidai, Aragaki, Masato, Sato, Masaaki, Okamoto, Kenzo, Ishibashi, Tetsuya, Oba, Koji, Kaji, Mitsuhito
Format: Article
Language:English
Subjects:
Adenocarcinoma - blood
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Adult
Aged
Aged, 80 and over
carcinoembryonic antigen (CEA)
Carcinoembryonic Antigen - blood
Carcinoma, Non-Small-Cell Lung - blood
Carcinoma, Non-Small-Cell Lung - pathology
Carcinoma, Non-Small-Cell Lung - surgery
Carcinoma, Squamous Cell - blood
Carcinoma, Squamous Cell - pathology
Carcinoma, Squamous Cell - surgery
Female
Follow-Up Studies
Humans
Lung Neoplasms - blood
Lung Neoplasms - pathology
Lung Neoplasms - surgery
Male
Middle Aged
Neoplasm Recurrence, Local - diagnosis
Neoplasm Recurrence, Local - etiology
Neoplasm Staging
non-small cell lung cancer
Pneumonectomy
postoperative
Predictive Value of Tests
preoperative
Preoperative Period
prognostic factor
Retrospective Studies
Risk Assessment
Risk Factors
Smoking - adverse effects
Survival Analysis
Treatment Outcome
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Summary:Background The cutoff value of preoperative serum carcinoembryonic antigen (CEA) levels has not been investigated using appropriate subgroup analyses for non‐small cell lung carcinoma (NSCLC). This study was undertaken to determine whether the most predictive preoperative CEA level for risk of recurrence differs according to histological type, and how smoking status influences predictive values in Stage I NSCLC. Methods Subjects comprised Stage I NSCLC patients [141 patients with adenocarcinoma (ADC) and 36 with squamous cell carcinoma (SCC)]. Results In patients with Stage I ADC, recurrence‐free survival (RFS) differed most significantly at a preoperative CEA level of 2.5 ng/ml, regardless of smoking status. Cases with preoperative CEA >2.5 ng/ml correlated with male sex, high maximum standard uptake value on 18F‐fluorodeoxyglucose positron emission tomography, poorer histopathological grade, lymphatic invasion, and smoking status. Importantly, preoperative CEA >2.5 ng/ml was identified as an independent risk factor for recurrence (P = 0.0015). Conversely, in patients with SCC, a preoperative CEA level of 3.0 ng/ml was the most predictive threshold. Conclusions Thresholds of preoperative CEA should be considered when predicting risk of relapse, even if these levels are within normal limits, as optimal cutoff levels may vary according to histological type. J. Surg. Oncol. 2013;107:619–624. © 2012 Wiley Periodicals, Inc.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.23293