Clinical value of routine serum squamous cell carcinoma antigen in follow-up of patients with early-stage cervical cancer.

Abstract

PURPOSE:

To investigate the contribution to recurrence detection and survival of serum squamous cell carcinoma antigen (SCC-ag) analysis in the follow-up of early-stage cervical cancer patients.

PATIENTS AND METHODS:

Follow-up data were evaluated in patients with early-stage squamous cell cervical cancer treated by radical hysterectomy and pelvic lymphadenectomy with or without radiotherapy. Routine serum SCC-ag determination was performed at each follow-up visit.

RESULTS:

Recurrent disease occurred in 35 (16%) of 225 patients and was preceded or accompanied by serum SCC-ag elevation 26 times (sensitivity, 74%). In five (14%) of these 35 patients, elevated serum SCC-ag was the first measured clinical indicator. Desite salvage therapy, all five patients died of disease. In the other 31 patients (21 with serum SCC-ag elevation), either symptoms and/or positive signs led to recurrence detection. Median survival time after recurrence was worse (9 months; range, 2 to 112+) for patients with an elevated serum SCC-ag value at recurrence in comparison with patients with normal serum SCC-ag values (20 months; range, 4 to 96; P <.01). In 23 of the 190 patients without recurrences, serum SCC-ag values became falsely elevated. In 16 of these 23 patients, the repeat sample after 6 weeks showed a normal SCC-ag, and in seven patients benign (especially skin) disorders were found.

CONCLUSION:

Serum SCC-ag analysis results in earlier recurrence detection in a small proportion (14%) of patients but did not contribute to better survival. As long as treatment possibilities for recurrent cervical cancer patients are not improved, serum SCC-ag analysis should not be carried out in routine follow-up.

• Authors: M D Esajas, J M Duk, H W de Bruijn, J G Aalders, P H Willemse, W Sluiter, B Pras, K ten Hoor, H Hollema, A G van der Zee
• Journal: Journal of clinical oncology : official journal of the American Society of Clinical Oncology (J Clin Oncol) Vol. 19 Issue 19 Pg. 3960-6 (Oct 01 2001) ISSN: 0732-183X [Print] United States
• PMID: 11579117 (Publication Type: Journal Article)

Chemical References

• Antigens, Neoplasm
• Biomarkers, Tumor
• Serpins
• squamous cell carcinoma-related antigen

Topics

• Antigens, Neoplasm (blood)
• Biomarkers, Tumor (blood)
• Carcinoma, Squamous Cell (immunology, pathology, radiotherapy, surgery)
• Female
• Follow-Up Studies
• Humans
• Neoplasm Recurrence, Local (immunology)
• Serpins
• Uterine Cervical Neoplasms (immunology, pathology, radiotherapy, surgery)