Persistently high serum carcinoembryonic antigen levels after surgery indicate poor prognosis in patients with stage I non-small-cell lung cancer.

BACKGROUND

The aim of this study is to evaluate the prognostic significance of preoperative and postoperative serum carcinoembryonic antigen (CEA) levels in patients with stage I non-small-cell lung cancer.

MATERIAL AND METHODS

A retrospective review of the medical records of 257 patients with stage I lung cancer undergoing surgical resection was performed. The clinical data of each patient was collected for analysis including age, smoking habits, gender, preoperative and postoperative serum CEA levels, tumor diameter, histologic type, visceral pleural invasion, pathologic stage, and type of operation.

RESULTS

Adenocarcinoma was more often associated with elevated preoperative CEA level compared with non-adenocarcinoma. Tumor histology, however, did not influence postoperative CEA levels. In the univariate analysis, age, serum CEA level, and pathologic stage were prognostic factors. Patients with normal preoperative serum CEA levels had better 5-y survival than patients with high preoperative serum CEA levels (71.1% versus 54.6%, P = 0.016). The patients with a persistently high serum CEA level after surgery had worst prognosis. Multivariate analysis demonstrated that older age (≥65) and persistently high serum CEA levels were independent significant prognostic factors in patients with stage I lung cancer.

CONCLUSIONS

Age (≥65 years) and preoperative and postoperative serum CEA levels are independent prognostic factors in patients with stage I lung cancer. Patients with a persistently high serum CEA level after surgery had worst survival, and may be good candidates for adjuvant chemotherapy.