Squamous Cell Carcinoma Antigen in Follow-Up of Cervical Cancer Treated With Radiotherapy: Evaluation of Cost-Effectiveness

Forni, Floreal H.; Ferrandina, Gabriella; Deodato, Francesco; Macchia, G.; Morganti, Alessio Giuseppe; Smaniotto, D.; Luzi, S.; D'Agostino, Giuseppe Roberto; Valentini, Vincenzo; Cellini, Numa; Giardina, Bruno; Scambia, Giovanni

doi:10.1016/j.ijrobp.2007.04.055

Cited by 42 publications

(44 citation statements)

References 16 publications

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“…13,33 However, some authors have debated its cost-effectiveness in follow-up. 34,35 The correlation of SCCAg levels with more advanced tumor classification also has been observed in other tumor sites, including head and neck sites; and, as in cervical cancer, a rise in SCCAg during follow-up may predate clinical recurrence. 36,37 The reported sensitivity of SCCAg in head and neck cancer is only 25.7% at diagnosis, although an abnormal level is more common with lymph node involvement.…”

Section: Discussionmentioning

confidence: 85%

Squamous cell carcinoma antigen

Williams

Swampillai

Osborne

et al. 2013

Cancer

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on behalf of the Mount Vernon Colorectal Cancer Network BACKGROUND: The objective of this retrospective study was to investigate the predictive value of pretreatment serum squamous cell carcinoma antigen (SCCAg) levels in 174 patients with squamous cell carcinoma of the anus who received concurrent chemoradiation between 1997 and 2010. METHODS: Pretreatment serum SCCAg measurements in patients with histologically diagnosed squamous cell carcinoma of the anal canal and margin who received chemoradiation were compared with clinical tumor classification and lymph node status for prognostic/predictive ability, including 1) tumor response after the completion of chemoradiation treatment, 2) disease recurrence, and 3) overall survival. Clinical measurements and scores were compared using Spearman rank tests, and survival was assessed in both univariate and multivariate survival analyses. RESULTS: The median pretreatment levels of SCCAg according to clinical tumor classification and clinical lymph node status were 0.8 lg/L in T1 tumors, 1.90 lg/L in T2 tumors, 2.5 lg/L in T3 tumors, 3.8 lg/L in T4 tumors, 1.35 lg/L in patients with N0 status, and 3.05 lg/L in patients with N01 status (correlation coefficient: T-classification, 0.43; lymph node status, 0.38; both P <.00001). Of the patients who had normal SCCAg levels, 95% achieved a complete response after initial treatment; and, of those who had elevated SCCAg levels, 86% achieved a complete response (P 5.05). Overall survival (hazard ratio, 2.5; P 5.007) and disease-free survival (hazard ratio, 2.2; P 5.058) were worse for those who had elevated pretreatment serum SCCAg concentrations. CONCLUSIONS: Pretreatment SCCAg levels in patients with squamous cell carcinoma of the anal canal and margin were correlated with clinical tumor classification and clinical lymph node status. Elevated levels of SCCAg were associated with a reduced chance of achieving a complete response and an increased chance of recurrence and death. The authors recommend further studies to determine the prognostic value of SCCAg in anal squamous cell carcinoma and suggest the potential use of SCCAg as a stratification factor in future trials.

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Section: Discussionmentioning

confidence: 85%

Squamous cell carcinoma antigen

Williams

Swampillai

Osborne

et al. 2013

Cancer

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“…Fourteen studies (36%) were analyses of empirical data from clinical trials. Among the remaining articles, three each were (nonrandomized) prospective [14,27,33] and retrospective studies [19,28,44]; one paper [49] was classified as a retrospective study plus modeling. The number of participants recruited in non-modeling studies (n = 20) ranged between 69 [42] and 472 [37], averaging at 231 patients.…”

Section: Resultsmentioning

confidence: 99%

Economic evaluations of follow-up strategies for cancer survivors: a systematic review and quality appraisal of the literature

Meregaglia

Cairns

2015

Expert Review of Pharmacoeconomics & Outcomes Research

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The aim of this study was to review and critically assess the health economics literature on post-treatment follow-up for adult cancer survivors. A systematic search was performed using PubMed, EMBASE and the Cochrane Library. The Consolidated Health Economic Evaluation Reporting Standards checklist was adopted to assess the quality of the included studies. Thirty-nine articles met the eligibility criteria. Around two thirds of the studies addressed the most common cancers (i.e., breast, colorectal, cervical and lung); 21 were based on a single clinical study, while the rest were modeling papers. All types of economic evaluations were represented other than cost-benefit analysis. The overall quality was generally high with an average proportion of 74% of checklist criteria fulfilled. The cost-effectiveness results supported the current trend towards less intensive, primary care-based and risk-adapted follow-up schemes.

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“…Also, its pretreatment levels was related to tumor stage, tumor size, depth of invasion, lymph-vascular space involvement, lymph node status and clinical outcome (Gadducci et al, 2004). Furthermore, it was the most accurate serologic tumor marker in cervical cancer staging and a cost-effective tool for monitoring of treatments (Esajas et al, 2001;Forni et al, 2007). The studies on relation of tumor markers and cervical cancer precursors are limited.…”

Section: Discussionmentioning

confidence: 99%

Application of Tumor Markers SCC-Ag, CEA, and TPA in Patients with Cervical Precancerous Lesions

Farzaneh

Shahghassempour²,

Noshine³

et al. 2014

Asian Pacific Journal of Cancer Prevention

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Background: To determine the potential clinical utility of tumor markers CEA, TPA, and SCC-Ag for early detection of cervical precancerous lesions. Materials and Methods: A case-control study was carried out on 120 women (46 patients with histologically confirmed cervical precancerous lesions and 74 healthy controls). The significance of serum selected tumor markers in early detection of cervical intraepithelial neoplasia (CIN) were assessed. Results: Of the case group, the rates of CIN I, II, III, was 69.6%, 23.9%, and 6.5%, respectively. According to the manufacturer's cut-off values of 2ng/ml, 5ng/ml, and 70 U/ml for SCC-Ag, CEA and TPA tests, in that order, SCC-Ag test had a sensitivity of 13%, but CEA and TPA tests could not distinguish between case and control groups. The diagnostic sensitivities were highest at cut-off values of 0.55 ng/ml for SCC-Ag, 2.6ng/ ml for CEA, and 25.5 U/ml for TPA which were 93%, 61%, and 50%, respectively. However, the area under the receiver operating characteristic curve was the largest for SCC-Ag (0.95 vs. 0.61 and 0.60 for CEA and TPA, respectively). Moreover, there was a highly significant direct correlation between SCC-Ag concentration and the degree of cervical precancerous lesions (r=0.847, p<0.001). Conclusions: The new cutoff of 0.5 for SCC-Ag test might be useful as a tumor marker in Iranian patients with CIN and it needs to be more evaluated by studies with larger populationa.

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Squamous Cell Carcinoma Antigen in Follow-Up of Cervical Cancer Treated With Radiotherapy: Evaluation of Cost-Effectiveness

Cited by 42 publications

References 16 publications

Squamous cell carcinoma antigen

Squamous cell carcinoma antigen

Economic evaluations of follow-up strategies for cancer survivors: a systematic review and quality appraisal of the literature

Application of Tumor Markers SCC-Ag, CEA, and TPA in Patients with Cervical Precancerous Lesions

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