Prognostic evaluation of preoperative serum tumor marker‐negative cases in non‐small cell lung cancer: A retrospective study

Abstract

Abstract Background The role of various serum tumor markers (TMs) has been reported in non‐small cell lung cancer (NSCLC). However, the prognosis of patients with multiple TM‐negative NSCLC remain unclear. Aims This study aimed to describe the characteristics and outcomes of patients with NSCLC undergoing surgery and to investigate their prognostic association with preoperative serum TM‐negative cases. Methods and results We retrospectively evaluated 442 patients who underwent complete resection of stage I NSCLC between January 2004 and December 2019. These 442 patients were classified into a group whose preoperative serum levels of carcinoembryonic antigen (CEA), cytokeratin‐19 fragment (CYFRA21‐1), carbohydrate antigen 19‐9 (CA19‐9), and squamous cell carcinoma antigen (SCC Ag) were all negative (TM‐negative group; n = 249, 56%) and a group with at least one positive marker (TM‐positive group; n = 193, 44%). Among all patients, the TM‐negative group showed higher 5‐year recurrence‐free survival (RFS) (92.6% vs. 79.1%; p < .01), and overall survival (OS) rates (86.3% vs. 68.6%; p < .01). After propensity score matching, patients in the TM‐negative group still exhibited good 5‐year RFS (92.1% vs. 81.4%; p = .01) and OS rates (87.6% vs. 72.6%; p < .01). Conclusion Our study suggests that NSCLC patients who are preoperatively negative for all serum TMs, such as CEA, CYFRA21‐1, CA19‐9, and SCC Ag, represent a subgroup with a particularly good prognosis.

Keywords

• biology
• lung cancer
• prognosis
• surgery
• tumor markers