Journal of Clinical Oncology, Vol 3, 1349-1354, Copyright © 1985 by American Society of Clinical Oncology
Carcinoembryonic antigen: a useful prognostic marker in small-cell lung cancer
JP Sculier, R Feld, WK Evans, FA Shepherd, G DeBoer, DG Malkin and A Malkin
Plasma carcinoembryonic antigen (CEA) was determined in 180 patients with
small-cell lung cancer (SCLC) before treatment. An abnormal level (greater
than or equal to 6 ng/mL) was found in 34% of patients tested. Patients
with extensive disease (39/83) had a significantly higher frequency of
abnormal CEA (P = .001) than those with limited disease (22/97). There was
a strong correlation between obtaining an objective response--particularly
a complete response (P = .00003)--and the absence of an elevated CEA.
Patients with an abnormal CEA also had a shorter survival time (P = .0007)
and the difference remained statistically significant after logrank
adjustment for extent of disease and ECOG (Eastern Cooperative Oncology
Group) performance status. There was also a negative correlation between
survival time and the quantitative level of CEA. In this series, only the
group of patients with normal initial CEA levels included all survivors
beyond 2.5 years. We conclude that CEA is a useful prognostic factor in
SCLC.
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