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Eur J Cardiothorac Surg 2007;32:440-444. doi:10.1016/j.ejcts.2007.06.011
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

The prognostic value of carcinoembryonic antigen in T1N1M0 and T2N1M0 non-small cell carcinoma of the lung

Department of General Thoracic Surgery, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8431, Japan

Received 15 January 2007; received in revised form 5 June 2007; accepted 11 June 2007.

^_* Corresponding author. Tel.: +81 55 948 3111; fax: +81 55 948 5088. (Email: ryuta.f{at}hotmail.co.jp).

Objective: To evaluate the significance of preoperative clinicopathological factors, including serum carcinoembryonic antigen (CEA), as well as postoperative clinicopathological factors in T1-2N1M0 patients with non-small cell lung cancer who underwent curative pulmonary resection. Methods: Twenty T1N1M0 disease patients and 25 T2N1M0 patients underwent standard surgical procedures between September 1996 and December 2005, and were found to have non-small lung cancer. As prognostic factors, we retrospectively investigated age, sex, Brinkman index, histologic type, primary site, tumor diameter, clinical T factor, clinical N factor, pathological T factor, preoperative serum CEA levels, surgical procedure, visceral pleural involvement, and the status of lymph node involvement (level and number). Results: The overall 5-year survival rate of all patients was 59.6%. In univariate analysis, survival was related to age (<70/70 years, p = 0.0079), site (peripheral/central, p = 0.043), and CEA level (<5.0/5.0 ng/ml, p = 0.0015). However, in multivariate analysis, CEA (<5.0/5.0 ng/ml) was the only independent prognostic factor; the 5-year survival of the patients with an elevated serum CEA level (5.0 ng/ml) was only 33.2% compared to 79.9% in patients with a lower serum CEA level (<5.0 ng/ml). Conclusions: An elevated serum CEA level (5.0 ng/ml) was an independent predictor of survival in pN1 patients except for T3 and T4 cases. Therefore, even in completely resected pN1 non-small cell lung cancer, patients with a high CEA level might be candidates for multimodal therapy.

Key Words: Lung cancer • Stage II • N1 • Carcinoembryonic antigen

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