Article ID | Journal | Published Year | Pages | File Type |
---|---|---|---|---|
2143269 | Lung Cancer | 2008 | 8 Pages |
SummaryThe aim of the study was to analyze the relation between tumor volume (Vpath), tumor marker index (TMI) and prognosis in 261 completely resected (R0) stages I and II non-small cell lung cancer (NSCLC) patients by univariate and multivariate analyses. Vpath was calculated as an ellipsoid body. TMI represents the geometric mean of normalized CYFRA 21-1 and CEA values. Patients with a Vpath ≤ 13.7 cm3 had a significantly better 5-year-survival rate than patients with a Vpath > 13.7 cm3 (78.1% vs. 47.9%; p < 0.001). Patients with a TMI ≤ 0.54 had a 5-year-survival rate of 79.1% compared to only 47.2% in patients with a TMI > 0.54 (p < 0.001). Besides age (>70 years), performance status and gender, both Vpath (>13.7 cm3) and TMI (>0.54) bore significance in the multivariate Cox model with a hazard ratio (HR) of 1.9 (95% CI: 1.1–3.3, p = 0.016) and 2.3 (95% CI: 1.3–4.2, p = 0.006), respectively. Based on a combination of Vpath and TMI, a low risk group (17% of the patients) with both parameters in the normal range could be identified. Patients with elevated Vpath or TMI (31%) had an intermediate HR of 3.4 (95% CI: 1.3–9.2). When both factors were elevated (52% of patients) the HR increased to 5.95 (95% CI: 2.4–14.9). The elevation of Vpath and TMI was found in 46.2% of stage I and in 59.1% of stage II. The 5-year-survival rates were found to be 89.1, 62.2 and 43.0%, respectively. In conclusion, elevated levels of TMI and Vpath have a strong negative prognostic impact on survival in operated early stage of NSCLC. These patients might be considered for adjuvant chemotherapy.