title: Prognosis of surgically resected lung cancer with extremely high preoperative serum carcinoembryonic antigen level.
abstract: OBJECTIVE
  The aim of this study was to investigate the prognosis of resected lung cancer patients with extremely high carcinoembryonic antigen (CEA) levels. Several reports have indicated that increased preoperative serum CEA levels are associated with a dismal outcome after surgery, whereas others have reported long-term survival among patients with extremely high preoperative CEA levels. We investigated whether preoperative serum CEA levels, especially extremely high levels, were related to the prognosis of non-small-cell lung cancer (NSCLC) after surgery.
  
  
  METHODS
  From September 1996 to January 2008, a total of 649 patients underwent surgical treatment for NSCLC at Juntendo University Hospital. We conducted a retrospective review to investigate the prognostic significance of the preoperative CEA level in these patients. We also investigated the prognosis of patients with an extremely high preoperative CEA level (>30 ng/ml).
  
  
  RESULTS
  The 5-year survival rates were 78.4% and 63.0% for patients with normal and abnormal preoperative CEA levels, respectively. The survival rate was significantly worse for patients with abnormal preoperative CEA levels (P = 0.0002). In all, 28 patients had preoperative CEA levels >30 ng/ml. Although most of these patients showed a poor prognosis, 7 (25.0%) were longterm survivors (>4 years).
  
  
  CONCLUSIONS
  An abnormal preoperative CEA level suggests a poor prognosis for patients with NSCLC after surgery. Nevertheless, a few patients with an extremely high preoperative CEA level had long-term survival. Even if the preoperative CEA is extremely high, we perform a careful survey for distant or intrathoracic metastases and should not overlook operable cases.
authors: Division of General Thoracic Surgery, Juntendo University School of Medicine, Hongo, Bunkyo-ku, Tokyo, Japan. nobumasa@juntendo.ac.jp
authors: Nobumasa
authors: N
authors: Takahashi
authors: Kenji
authors: K
authors: Suzuki
authors: Kazuya
authors: K
authors: Takamochi
authors: Shiaki
authors: S
authors: Oh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002272:Carcinoembryonic Antigen / Q000097:blood*; D002289:Carcinoma, Non-Small-Cell Lung / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D007564:Japan; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000276:immunology / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011013:Pneumonectomy / Q000009:adverse effects / Q000401:mortality; D057234:Preoperative Period; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome; D015854:Up-Regulation
chemical_list: D002272:Carcinoembryonic Antigen