Preoperative CYFRA 21-1 levels as a prognostic factor in c-stage I non-small cell lung cancer

Suzuki, Hisashi; Ishikawa, Shigemi; Satoh, Hiroaki; Ishikawa, Hiroichi; Sakai, Mitsuaki; Yamamoto, Tatsuo; Onizuka, Masataka; Sakakibara, Yuzuru
October 2007
European Journal of Cardio-Thoracic Surgery;Oct2007, Vol. 32 Issue 4, p648
Academic Journal
Abstract: Objective: The clinical importance of preoperative CYFRA 21-1 measurement in early-stage non-small cell lung cancer (NSCLC) is still unclear. The aim of this study is to clarify the prognostic value of preoperative CYFRA 21-1 levels in clinical stage (c-stage) I NSCLC. Methods: The records of 101 c-stage I NSCLC patients who had undergone complete resection were analyzed to correlate preoperative CYFRA 21-1 levels to both the pathologic factors of resected specimens and postoperative outcomes. The cut-off value was set at 3.5ng/ml. Results: Six cases (5.9%) showed high CYFRA 21-1 (≥3.5ng/ml). The 5-year survival of normal and high CYFRA 21-1 groups was 83.3% and 50.0%, respectively. Patients with high CYFRA 21-1 had significantly poor outcomes (P =0.006). In univariate analysis, preoperative serum CYFRA 21-1 level, pT, pN, and p-stage were significantly associated with prognosis. Multivariate analysis showed that only CYFRA 21-1 level was retained as an independent prognostic factor (relative risk=9.79, P =0.002). Conclusions: CYFRA 21-1 is an independent predictor of poor outcome for c-stage I NSCLC. Elevated preoperative CYFRA 21-1 levels in early-stage NSCLC may indicate a subgroup at high risk of early death, which has the potential for better survival with additional systemic chemotherapy.


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