High serum LDH, poor PS, high serum ALP, >1 metastatic sites, age>65, high serum CEA, mobility problems (as coded 2–3) (Figure 2), pain/discomfort problems (as coded 2–3) and anxiety/depression problems (as coded 2–3) were associated with a poorer prognosis. This evidence concerns the gene CEACAM5 and major depressive disorder.