A clinicopathological study of resected small-sized squamous cell carcinomas of the peripheral lung: Prognostic significance of serum carcinoembryonic antigen levels

Abstract

Purpose: The purpose of this retrospective study was to evaluate common clinicopathological factors and clarify the prognostic factors of small-sized peripheral-lung squamous cell carcinomas. Methods: We retrospectively reviewed 71 patients with peripheral squamous cell carcinoma ≤3 cm in diameter, who were surgically treated between January 1989 and December 2010. Patients undergoing partial lung resection without lymph node dissection were excluded. The median follow-up for living patients was 63 months. Results: The overall 3- and 5-year survival rates were 83.9% and 74.7%, respectively. Although the ROC curve of serum carcinoembryonic antigen (CEA) levels showed marginally significance (P = 0050), multivariate analyses revealed that age (P = 0043), lymph node metastasis (P = 0004), and preoperative serum carcinoembryonic antigen (CEA) level (P = 0037) were independent prognostic factors. For pathologic N0 patients, there was a significant difference for recurrence-free survival based on CEA levels: patients with normal CEA levels (n = 40), 5-year-recurrence-free rate = 935%; elevated CEA (n = 14), 5-year-recurrence-free rate = 727% (P = 00160). The distribution of tumor cells immunoreactive for CEA was significantly associated with serum CEA levels (P = 0033). Conclusion: Age, lymph node metastasis, and serum CEA level are independent prognostic factors for small-sized peripheral-lung squamous cell carcinoma. © 2012 The Editorial Committee of Annals of Thoracic and Cardiovascular Surgery. All rights reserved.