Pretreatment serum CEA level predicts survival in NSCLC

Pretreatment level of serum carcinoembryonic antigen (CEA) is independently associated with overall and disease-free survival among patients with nonsmall cell lung cancer (NSCLC), reports a study. The same marker is also used for the prognosis of patients with the same pathologic stages.

In this retrospective cohort study, the authors assessed a total of 1,130 patients with NSCLC treated by thoracic surgery with pretreatment serum CEA concentrations above or below 5 ng/mL. They analysed the intergroup variance using propensity score matching, Kaplan-Meier survival analysis, and Cox proportional hazard regression models.

Cumulative meta-analysis was then conducted to combine the overall/disease-free hazard ratios (HRs) of the current study with those of previously published studies to achieve the highest level of evidence.

Survival was significantly different between NSCLC patients with high and low serum CEA levels. In Cox univariate analysis, the overall and disease-free HRs were 1.595 (95 percent confidence interval [CI], 1.329‒1.863; p=0.004) and 1,498 (95 percent CI, 1.271‒1.881; p=0.004), respectively, in patients with high CEA concentration compared with those with low CEA level.

In multivariate analysis, the corresponding adjusted HRs were 1.586 (95 percent CI, 1.398‒1.812; p=0.016) and 1.413 (95 percent CI, 1.22‒1.734; p=0.022).

“The … meta-analysis showed that the cumulative overall HR was in accord with previous studies, and the cumulative disease-free HR [was] statistically significant,” the authors said.

CEA is the most used tumour marker for NSCLC.