Utility of serum squamous cell carcinoma antigen levels at the time of recurrent cervical cancer diagnosis in determining the optimal treatment choice.
10.3802/jgo.2013.24.4.321
- Author:
Kotaro SHIMURA
1
;
Seiji MABUCHI
;
Takeshi YOKOI
;
Tomoyuki SASANO
;
Kenjirou SAWADA
;
Toshimitsu HAMASAKI
;
Tadashi KIMURA
Author Information
1. Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan. smabuchi@gyne.med.osaka-u.ac.jp
- Publication Type:Original Article
- Keywords:
Decision-making;
Recurrent cervical cancer;
Squamous cell carcinoma antigen;
Survival
- MeSH:
Antigens, Neoplasm;
Carcinoma, Squamous Cell;
Decision Making;
Humans;
Multivariate Analysis;
Recurrence;
Serpins;
Uterine Cervical Neoplasms
- From:Journal of Gynecologic Oncology
2013;24(4):321-329
- CountryRepublic of Korea
- Language:English
-
Abstract:
OBJECTIVE: To 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. METHODS: Clinical 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. RESULTS: Serum 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 > or =14.0 ng/mL, salvage treatment with radiotherapy had only a minimal impact on postrecurrence survival. CONCLUSION: The serum SCC-Ag level measured when cervical cancer recurrence is diagnosed can be useful for deciding upon the appropriate salvage treatment.
