Utility of serum squamous cell carcinoma antigen levels at the time of recurrent cervical cancer diagnosis in determining the optimal treatment choice

Abstract

ObjectiveTo investigate the utility of serum squamous cell carcinoma antigen (SCC-Ag) levels upon the diagnosis of recurrent cervical cancer for decision making in patient management.MethodsClinical records from 167 cervical cancer patients who developed recurrence between April 1996 and September 2010 were reviewed. A Cox proportional hazards regression model was used to investigate the prognostic significance of serum SCC-Ag levels at the time of recurrence. The effects of various salvage treatments on survival outcomes of recurrent cervical cancer were examined with respect to serum SCC-Ag levels.ResultsSerum SCC-Ag levels were elevated (>2.0 ng/mL) in 125 patients (75%) when recurrence was diagnosed. These patients exhibited significantly shorter postrecurrence survival than those with normal SCC-Ag levels (log-rank; p=0.033). Multivariate analyses revealed that an elevated serum SCC-Ag level was an independent prognostic factor for poor postrecurrence survival. In patients with SCC-Ag levels <14.0 ng/mL, radiotherapy or surgery resulted in improved survival compared with chemotherapy or supportive care. In contrast, in patients with SCC-Ag levels of ≥14.0 ng/mL, salvage treatment with radiotherapy had only a minimal impact on postrecurrence survival.ConclusionThe serum SCC-Ag level measured when cervical cancer recurrence is diagnosed can be useful for deciding upon the appropriate salvage treatment.

The Value of Diffusion-Weighted Imaging in Predicting the Prognosis of Stage IB-IIA Cervical Squamous Cell Carcinoma After Radical Hysterectomy

“…Some studies have also shown that serum SCC-Ag levels can be adopted for predicting earlier recurrence of cervical cancer. 13,16 Diffusion-weighted imaging is a functional imaging technique that indirectly reflects the microscopic motion of water molecules and the degree of water diffusion in biological tissues and is related to the tissue cellularity and cell membrane integrity. This technique allows the quantification of diffusion by calculating the ADC, and the decrease of ADC values derived from DWI in malignant tumors may be caused by their increased tissue cellularity or cell density and less extracellular space.…”

“…13 Its expression is increased in cervical neoplasms. Serum SCC-Ag is elevated in 28% to 88% of patients with SCC at the time of initial diagnosis.…”

“…16 Serum SCC-Ag levels have been adopted successfully for predicting recurrence. 13 It has been shown that SCC-Ag has an area under the curve (AUC) of 0.822 (95% confidence interval [95% CI], 0.744Y0.900) for recurrence evaluation. 17 Rises in SCC-Ag significantly increase the odds for recurrence.…”

Squamous cell carcinoma antigen in cervical cancer and beyond

“…In a previous study, serum SCC-Ag analysis results in earlier recurrence detection in a small proportion (14%) of patients but did not contribute to better survival [11]. On the other hand, another study reported that salvage treatment with radiotherapy or surgery resulted in improved survival compared with chemotherapy or palliative care in patients with serum SCC-Ag levels of less than <14.0 ng/mL at the time of recurrence [12]. …”

Suivi après radiothérapie pour un cancer du col utérin

“…L'augmentation du marqueur précédait les symptômes de 5 mois. Néanmoins, au-delà du risque de faux positif avéré, le bénéfice clinique en termes de survie globale est controversé [40,41]. Par ailleurs, le rapport coût−bénéfice n'a pas été réévalué depuis l'avènement de la chimioradiothérapie pelvienne pour les tumeurs localement évoluées.…”