1310P - Prognostic impact of serum CYFRA 21-1 in advanced lung adenocarcinoma

Date 29 September 2012
Event ESMO Congress 2012
Session Poster presentation I
Topics Non-Small-Cell Lung Cancer, Metastatic
Translational Research
Presenter Akira Ono
Authors A. Ono1, T. Takahashi2, H. Akamatsu3, T. Taira3, T. Shukuya3, H. Kenmotsu3, T. Naito3, H. Murakami3, M. Endo4, N. Yamamoto5
  • 1Thoracic Oncology Dept., Shizuoka Cancer Center, 411-8777 - Shizuoka/JP
  • 2Division Of Thoracic Oncology, Shizuoka Cancer Center, JP-411-8777 - Shizuoka/JP
  • 3Division Of Thoracic Oncology, Shizuoka Cancer Center, 411-8777 - Shizuoka/JP
  • 4Division Of Diagnostic Radiology, Shizuoka Cancer Center, 411-8777 - Shizuoka/JP
  • 5Thoracic Oncology, Shizuoka Cancer Center, 411-8777 - Shizuoka/JP

Abstract

Background

Serum CYFRA 21-1 is one of the most important serum markers in diagnosing non-small cell lung cancer (NSCLC), especially squamous-cell carcinoma. It is not known whether pretreatment serum CYFRA 21-1 values (PCV) have prognostic implications in advanced lung adenocarcinoma. The aim of this study was to evaluate the prognostic implications of PCV in advanced lung adenocarcinoma.

Material and methods

Out of 424 newly diagnosed lung cancer patients (pts) at our institution during the period April 2008- June 2010, we retrospectively reviewed 284 consecutive pts who were diagnosed with advanced lung adenocarcinoma and had been treated with systemic chemotherapy. Survival was estimated using the Kaplan-Meier method. A log-rank test was performed to test the significance of differences in the overall survival among the groups. A multivariate analysis using the Cox proportional hazards model was used to establish the association between various prognostic factors and survival.

Results

One hundred twenty one pts (43%) had activating EGFR mutations (Mt+) and 163 pts (57%) had EGFR wild type (Mt-). The median follow-up time was 29.7 months (range: 2.8- 75.7 months). In univariate analysis, gender (male/ female), ECOG performance status (PS) (0-2/ 3-4), PCV (< 2.2ng/ml, > 2.2ng/ml), EGFR mutation (Mt + / Mt-), and smoking history (yes/ no) were favorable prognostic factors (p= 0.01, p< 0.0001, p< 0.0001, p< 0.0001, p= 0.0008 respectively), but not age ([< 70, > 70], p = 0.67). A Cox's multivariate analysis showed that PCV (< 2.2ng/ml) was significantly associated with prolonged survival (p< 0.0001, hazard ratio: 0.38, 95% CI 0.32-0.63), when adjusted by PS (p< 0.0001), EGFR mutation status (p< 0.0001), gender (p= 0.37), and smoking history (p= 0.11). Furthermore, patients with Mt+ and CYFRA < 2.2ng/ml (n= 70) had a better prognosis than those with Mt+ and CYFRA > 2.2ng/ml (n= 48) (median survival time [MST]: 52.4 vs. 21.0 months, p< 0.0001), and those with Mt- and CYFRA < 2.2ng/ml (n= 78) had a better prognosis than Mt- and CYFRA > 2.2ng/ml (n = 86) (MST: 24.1 vs. 10.2 months, p<0.0001).

Conclusions

PCV should be regarded as a potential independent prognostic factor in both Mt+ and Mt- advanced lung adenocarcinoma.

Disclosure

All authors have declared no conflicts of interest.