RT Journal Article
SR Electronic
T1 Identification of p-stage I NSCLC patients with high risk of recurrence and poor prognosis by tumor marker index (TMI)
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP p1963
VO 38
IS Suppl 55
A1 Muley, Thomas
A1 Hoffmann, Hans
A1 Dienemann, Hendrik
A1 Thomas, Michael
A1 Herth, Felix
A1 Meister, Michael
YR 2011
UL http://erj.ersjournals.com/content/38/Suppl_55/p1963.abstract
AB TMI has been shown to be a prognostic factor in early stage NSCLC (Muley et al., Lung Cancer, 60: 408-415, 2008).The objective of the study was to analyse the value of TMI to predict tumour relapse in completely resected p-stage I NSCLC patients.112 patients entered the study (71 male/41 female; 37 SCC, 59 AC, 16 other NSCLC; relapse: n=33; death: n=20; median follow-up: 39.3 months). Preoperative markers were measured with immunoassays (Roche, Mannheim, Germany). TMI is defined as the geometric mean of normalized CEA and CYFRA 21-1 values. Statistical analysis was done with SPSS 18.0 (Chicago, USA).CEA (HR: 2.3, p=0.015) and CYFRA 21-1 (HR: 3.0, p=0.002) differed significantly between patients with low and high risk of tumour relapse. The differentiation was improved (HR: 3.6) by using TMI (cut-off 0.58). 3-year disease-free survival was 83.8% and 54.0%, respectively (p=0.001). 8/53 patients in the low risk group and 25/59 patients in the high risk group had tumour recurrence. The overall survival was 95.4% in low risk and 77.5% in high risk patients (p=0.001). TMI was found to be a significant prognostic factor (DFS, OS) in multivariate analyses. A small effect of adjuvant chemotherapy (n=20) could be seen in the high risk group. The relapse rate was 2/8 patients with adjuvant chemotherapy compared to 23/51 patients without adjuvant chemotherapy. In contrast, patients receiving adjuvant chemotherapy in the low risk group had a higher rate (5/12) compared to patients without adjuvant chemotherapy (3/41).Patients with elevated TMI levels were shown to be at an increased risk of relapse and might therefore be appropriate candidates for adjuvant therapy.