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Eur J Cardiothorac Surg 2007;32:648-652. doi:10.1016/j.ejcts.2007.06.032
Copyright © 2007, European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved

Preoperative CYFRA 21-1 levels as a prognostic factor in c-stage I non-small cell lung cancer

Hisashi Suzukia, Shigemi Ishikawaa,*, Hiroaki Satohb, Hiroichi Ishikawac, Mitsuaki Sakaia, Tatsuo Yamamotoa, Masataka Onizukaa, Yuzuru Sakakibaraa

a Department of Surgery, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
b Department of Internal Medicine, Graduate School of Comprehensive Human Science, University of Tsukuba, 1-1-1 Tennoudai, Tsukuba, Ibaraki, 305-8575, Japan
c Department of Internal Medicine, Tsukuba Medical Center Hospital, 1-3-1 Amakubo, Tsukuba, Ibaraki, 305-8558, Japan

Received 19 March 2007; received in revised form 21 June 2007; accepted 26 June 2007.

* Corresponding author. Tel.: +81 29 853 3210; fax: +81 29 853 3097. (Email: ishikawa{at}md.tsukuba.ac.jp).

Objective: The clinical importance of preoperative CYFRA 21-1 measurement in early-stage non-small cell lung cancer (NSCLC) is still unclear. The aim of this study is to clarify the prognostic value of preoperative CYFRA 21-1 levels in clinical stage (c-stage) I NSCLC. Methods: The records of 101 c-stage I NSCLC patients who had undergone complete resection were analyzed to correlate preoperative CYFRA 21-1 levels to both the pathologic factors of resected specimens and postoperative outcomes. The cut-off value was set at 3.5 ng/ml. Results: Six cases (5.9%) showed high CYFRA 21-1 (≥3.5 ng/ml). The 5-year survival of normal and high CYFRA 21-1 groups was 83.3% and 50.0%, respectively. Patients with high CYFRA 21-1 had significantly poor outcomes (P = 0.006). In univariate analysis, preoperative serum CYFRA 21-1 level, pT, pN, and p-stage were significantly associated with prognosis. Multivariate analysis showed that only CYFRA 21-1 level was retained as an independent prognostic factor (relative risk = 9.79, P = 0.002). Conclusions: CYFRA 21-1 is an independent predictor of poor outcome for c-stage I NSCLC. Elevated preoperative CYFRA 21-1 levels in early-stage NSCLC may indicate a subgroup at high risk of early death, which has the potential for better survival with additional systemic chemotherapy.

Key Words: CYFRA 21-1 • Early-stage diseases • Non-small cell lung cancer • Prognostic factors • Thoracic surgery • Tumor markers






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Copyright © 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier. All rights reserved.