Combined Evaluation of Postoperative Serum Levels of Carcinoembryonic Antigen Less than or Equal to 2.5 ng/ml and Absence of Vascular Invasion may Predict no Recurrence of Stage I Adenocarcinoma Lung Cancer

Autor: Ji Ichiro Sasaki, Hirotsugu Kohrogi, Syoh Saeki, Kosuke Kashiwabara, Masanobu Nomura
Rok vydání: 2008
Předmět:
Adult
Male
Pulmonary and Respiratory Medicine
Uracil/tegafur (UFT)
medicine.medical_specialty
Lung Neoplasms
Multivariate analysis
Adenocarcinoma
Predictors for postoperative recurrence
Gastroenterology
Vascular invasion
Carcinoembryonic antigen
Internal medicine
medicine
Humans
Neoplasm Invasiveness
Postoperative Period
Pneumonectomy
Aged
Neoplasm Staging
Aged
80 and over
Receiver operating characteristics (ROC) curve
Neovascularization
Pathologic
biology
Receiver operating characteristic
Proportional hazards model
business.industry
Hazard ratio
Middle Aged
Cox proportional-hazards model
Prognosis
medicine.disease
Confidence interval
Adjuvant chemotherapy
Carcinoembryonic Antigen
Surgery
Treatment Outcome
ROC Curve
Oncology
Chemotherapy
Adjuvant
Lymphatic Metastasis
biology.protein
Female
Neoplasm Recurrence
Local
business
Follow-Up Studies
Zdroj: Journal of Thoracic Oncology. 3:1416-1420
ISSN: 1556-0864
DOI: 10.1097/jto.0b013e31818dda85
Popis: Study Objectives It has been reported that high levels of serum carcinoembryonic antigen (CEA) after surgery, or the presence of vascular invasion or both, are strong indicators of postoperative recurrence in patients with non-small cell lung cancer. The purpose of this study is to evaluate which kind of patients with p-stage I adenocarcinoma need adjuvant chemotherapy, using those predictors. Patients and Methods We studied 136 patients with curatively resected p-stage I adenocarcinoma during the 7-year period of January 1, 2000 to December 31, 2006. Receiver operating characteristics curves were constructed using postoperative CEA levels measured 2 months after surgery. Clinical variables were examined as possible predictors of disease recurrence by multivariate analysis using the Cox proportional-hazards model. Results The median time of follow-up after surgery was 28.3 months. Fifteen (11%) of 136 patients had postoperative recurrence (7 p-stage IA cases and 8 p-stage IB cases). The presence of vascular invasion (hazard ratio: 10.229, 95% confidence intervals: 2.811–37.223, p = 0.0004) and high postoperative CEA levels (hazard ratio: 1.650, 95% confidence intervals: 1.196–2.275, p = 0.0023) increased the risk of recurrence. There was no recurrence in patients who had both postoperative CEA levels less than or equal to 2.5 ng/ml and no vascular invasion. Conclusion Combined evaluation of postoperative CEA levels and vascular invasion makes it possible to predict disease recurrence in the curatively resected p-stage I adenocarcinoma patients.
Databáze: OpenAIRE
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