Ho-ho-ho! Gather around, my dear friends, for I have a tale to tell, not of reindeers and elves, but of a journey through the frosty realm of non-small cell lung cancer (NSCLC) research. In a land far, far away, where scientists toil not with toys but with data, a group of intrepid researchers embarked on an expedition to explore the mysteries of CEA, a marker not for good behavior, but for cancer progression.

In this retrospective sleigh ride through the medical records of 2,959 patients who underwent surgery for stage I-III NSCLC, our heroes didn’t just peek at CEA levels at a single point in time—oh no! They looked at them over time, charting their course like I chart my journey on Christmas Eve.

Using a magical tool known as the latent class growth mixture model, they discovered four distinct groups of CEA trajectories, akin to the different paths my reindeer take through the night sky: low-stable, decreasing, early-rising, and later-rising. Each group, they found, had a different tale to tell about the patient’s journey with NSCLC.

The low-stable group, much like homes with chimneys easy to navigate, had the best outlook. The other groups, however, faced more perilous journeys, with the risk of death being significantly higher—like trying to deliver presents during a blizzard.

Furthermore, the story deepened as they explored the long-term cumulative burden of CEA, finding that higher levels were like heavier sacks of coal, weighing down the patients’ chances of survival. The five-year overall survival rates, they noted, dropped from a jolly 62.3% to a rather somber 33.0% as the cumulative CEA burden increased.

But there was a glimmer of hope, much like the star atop the Christmas tree, for those in the decreasing CEA group. Depending on their cumulative CEA burden, their survival rates could be as high as 77.9% or as low as 47.1%.

Alas, the tale took a darker turn with the revelation that patients with rising CEA trajectories and high cumulative burdens were more likely to develop bone metastasis, a reminder that not all stories have happy endings.

In the end, our researchers, much like elves wrapping up their findings in neat packages, concluded that the longitudinal trajectory patterns and long-term cumulative burden of CEA were crucial markers on the journey of NSCLC, guiding the way for better postoperative surveillance.

So, as we close this chapter and look towards the twinkling stars on this cold winter’s night, let us take heart in the knowledge gained and the hope it brings for the future. Merry Christmas to all, and to all a good night!