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Prognostic Significance of CYFRA21-1, CEA and Hemoglobin in Patients with Esophageal Squamous Cancer Undergoing Concurrent Chemoradiotherapy

  • Zhang, Hai-Qin (Department of Radiation Oncology, Shandong Cancer Hospital) ;
  • Wang, Ren-Ben (Department of Radiation Oncology, Shandong Cancer Hospital) ;
  • Yan, Hong-Jiang (Department of Radiation Oncology, Shandong Cancer Hospital) ;
  • Zhao, Wei (Department of Radiation Oncology, Shandong Cancer Hospital) ;
  • Zhu, Kun-Li (Department of Radiation Oncology, Shandong Cancer Hospital) ;
  • Jiang, Shu-Mei (Department of Radiation Oncology, Shandong Cancer Hospital) ;
  • Hu, Xi-Gang (Department of Radiation Oncology, Shandong Cancer Hospital) ;
  • Yu, Jin-Ming (Department of Radiation Oncology, Shandong Cancer Hospital)
  • Published : 2012.01.31

Abstract

Purpose: To evaluate the prognostic value of serum CYFRA21-1, CEA and hemoglobin levels regarding long-term survival of patients with esophageal squamous cell carcinoma (ESCC) treated with concurrent chemoradiotherapy (CRT). Methods: Age, gender, Karnofsky Performance Status (KPS), tumor location, tumor length, T stage, N stage and serum hemoglobin, and CYFRA21-1 and CEA levels before concurrent CRT were retrospectively investigated and related to outcome in 113 patients receiving 5-fluorouracil and cisplatin combined with radiotherapy for ESCC. The Kaplan-Meier method was used to analyze prognosis, the log-rank to compare groups, the Cox proportional hazards model for multivariate analysis, and ROC curve analysis for assessment of predictive performance of biologic markers. Results: The median survival time was 20.1 months and the 1-, 2-, 3-, 5- year overall survival rates were 66.4%, 43.4%, 31.9% and 15.0%, respectively. Univariate analysis showed that factors associated with prognosis were KPS, tumor length, T-stage, N-stage, hemoglobin, CYFRA21-1 and CEA level. Multivariate analysis showed T-stage, N-stage, hemoglobin, CYFRA21-1 and CEA level were independent predictors of prognosis. By ROC curve, CYFRA21-1 and hemoglobin showed better predictive performance for OS than CEA (AUC= 0.791, 0.704, 0.545; P=0.000, 0.000, 0.409). Conclusions: Of all clinicopathological and molecular factors, T stage, N stage, hemoglobin, CYFRA21-1 and CEA level were independent predictors of prognosis for patients with ESCC treated with concurrent CRT. Among biomarkers, CYFRA21-1 and hemoglobin may have a better predictive potential than CEA for long-term outcomes.

Keywords

References

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