title: Clinical value of p53, c-erbB-2, CEA and CA125 regarding relapse, metastasis and death in resectable non-small cell lung cancer.
abstract: The prognostic value of p53 and c-erbB-2 immunostaining and preoperative serum levels of CEA and CA125 was investigated in a prospective multicentric study including 465 consecutive non-small cell lung cancer (NSCLC) patients with resectable tumors. Four end-points were used: lung cancer death, first relapse (either locoregional or metastasis), loco-regional recurrence and metastasis development. Standard statistical survival methods (Kaplan-Meier and Cox regression) were used. The specificity of the prognostic effect across different types of tumors was also explored, as had been planned in advance. Our results showed, once again, that pathological T and N classifications continue to be the strongest predictors regarding either relapse or mortality. Three of the studied markers seemed to add further useful information, however, but in a more specific context. For example, increased CEA concentration defined a higher risk population among adenocarcinomas but not among people with squamous tumors; and p53 overexpression implied a worse prognosis mainly in patients with well differentiated tumors. The analysis of type of relapse proved to be very informative. Thus, CA125 level was associated with a worse prognosis mainly related with metastasis development. Another interesting result was the influence of smoking, which showed a clear dose-response relationship with the probability of metastasis. For future studies, we recommend the inclusion of different endpoints, namely considering the relationship of markers with the type of relapse involved in lung-cancer recurrence. They can add useful information regarding the complex nature of prognosis.
authors.affiliation: Instituto de Salud Carlos III, Madrid, Spain. mpollan@isciii.es
authors.forename: Marina
authors.initials: M
authors.lastname: Pollán
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Varela
authors.forename: Antonio
authors.initials: A
authors.lastname: Torres
authors.forename: Mercedes
authors.initials: M
authors.lastname: de la Torre
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Ludeña
authors.forename: Maria Dolores
authors.initials: MD
authors.lastname: Ortega
authors.forename: Joaquín
authors.initials: J
authors.lastname: Pac
authors.forename: Jorge
authors.initials: J
authors.lastname: Freixenet
authors.forename: Guillermo
authors.initials: G
authors.lastname: Gómez
authors.forename: Fernando
authors.initials: F
authors.lastname: Sebastián
authors.forename: Manuel
authors.initials: M
authors.lastname: Díez
authors.forename: Ricardo
authors.initials: R
authors.lastname: Arrabal
authors.forename: Emili
authors.initials: E
authors.lastname: Canalís
authors.forename: Javier
authors.initials: J
authors.lastname: García-Tirado
authors.forename: Aurelio
authors.initials: A
authors.lastname: Arnedillo
authors.forename: Juan José
authors.initials: JJ
authors.lastname: Rivas
authors.forename: Joan
authors.initials: J
authors.lastname: Minguella
authors.forename: Ana
authors.initials: A
authors.lastname: Gómez
authors.forename: Mauricio
authors.initials: M
authors.lastname: García
authors.forename: Nuria
authors.initials: N
authors.lastname: Aragonés
authors.forename: Beatriz
authors.initials: B
authors.lastname: Pérez-Gómez
authors.forename: Gonzalo
authors.initials: G
authors.lastname: López-Abente
authors.forename: Rogelio
authors.initials: R
authors.lastname: González-Sarmiento
authors.forename: Jose María
authors.initials: JM
authors.lastname: Rojas
mesh_terms: D000230:Adenocarcinoma / Q000097:blood / Q000401:mortality / Q000473:pathology; D014408:Biomarkers, Tumor / Q000032:analysis / Q000097:blood; D018394:CA-125 Antigen / Q000097:blood*; D002272:Carcinoembryonic Antigen / Q000097:blood*; D018287:Carcinoma, Large Cell / Q000097:blood / Q000401:mortality / Q000473:pathology; D002289:Carcinoma, Non-Small-Cell Lung / Q000097:blood / Q000401:mortality / Q000473:pathology*; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000401:mortality / Q000473:pathology; D006801:Humans; D008175:Lung Neoplasms / Q000097:blood / Q000401:mortality / Q000473:pathology*; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis*; D015203:Reproducibility of Results; D016019:Survival Analysis; D013997:Time Factors; D016159:Tumor Suppressor Protein p53 / Q000032:analysis*
chemical_list: D014408:Biomarkers, Tumor; D018394:CA-125 Antigen; D002272:Carcinoembryonic Antigen; D018719:Erb-b2 Receptor Tyrosine Kinases; D016159:Tumor Suppressor Protein p53