Survival prediction and adjuvant chemotherapy based on tumor marker for stage IB lung adenocarcinoma

Abstract Background We aimed to find out the prognosis of stage IB invasive lung adenocarcinoma according to perioperative tumor markers (TMs), especially carcinoembryonic antigen (CEA), and to determine whether TMs could guide adjuvant chemotherapy. Methods Stage IB adenocarcinoma patients were selected from two medical centers in Shanghai between January 2007 and December 2013. Perioperative TMs including preoperative and postoperative TMs were stratified into normal level, CEA normal and CEA elevated, respectively. Propensity score matching was analyzed for eliminating variable differences between chemotherapy and observation groups. Univariable and multivariable cox regressions were conducted to discovery the prognostically independent risk factors. Kaplan-Meier curves were plotted and testified by Log-rank test. Subgroup analysis was performed to investigate chemotherapy benefit according to postoperative TMs. Results Postoperative CEA elevated (HR=6.783, 95% CI 2.534-18.162, p Conclusions Postoperative CEA normal and CEA elevated were two independent risk indicators for poorer clinical outcome instead of preoperative ones. Chemotherapy failed to improve clinical outcomes when postoperative TMs elevated. Importantly, chemotherapy could not even be recommended when postoperative TMs was in a normal level.