Premium
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
Author(s) -
Kato Tatsuya,
Ishikawa Keidai,
Aragaki Masato,
Sato Masaaki,
Okamoto Kenzo,
Ishibashi Tetsuya,
Oba Koji,
Kaji Mitsuhito
Publication year - 2012
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23293
Subject(s) - carcinoembryonic antigen , medicine , stage (stratigraphy) , lymphovascular invasion , adenocarcinoma , lung cancer , histology , gastroenterology , oncology , preoperative care , carcinoma , predictive value of tests , proportional hazards model , standardized uptake value , cancer , positron emission tomography , radiology , metastasis , paleontology , biology
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 18 F‐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.