Clinical value of routine serum squamous cell carcinoma antigen in follow-up of patients with locally advanced cervical cancer treated with radiation or chemoradiation
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ObjectiveThe objective of this study was to evaluate the clinical benefits of routine squamous cell carcinoma antigen (SCC-Ag) monitoring of patients with locally advanced cervical squamous cell carcinoma treated with radiation or chemoradiation. MethodsA total of 53 patients with recurrent cervical squamous cell carcinoma treated with radiotherapy or chemoradiation were enrolled in this study. A retrospective review of medical records was conducted. The role of routine monitoring of serum SCC-Ag was evaluated in terms of cost effectiveness and effect on survival after diagnosis of recurrence. ResultsSerum SCC-Ag abnormality (≥2.5 ng/mL) was observed in 62.3% of patients when recurrent disease was diagnosed. The first indicator of relapse was abnormal serum SCC-Ag level in 21 patients (39.6%), 10 of whom had asymptomatic recurrent disease amenable to salvage therapy. Adding SCC-Ag measurement to the basic follow up protocol improved the sensitivity for detecting recurrence (The sensitivity of the basic protocol vs. addition of SCC-Ag: 49.1% vs. 88.7%, P<0.001). Twenty-three patients who were candidates for salvage therapy with curative intent showed better survival compared with those who were not candidates for therapy (5-year survival: 36.6% vs. 0%, P=0.012). ConclusionSurveillance with routine serum SCC-Ag monitoring can better detect asymptomatic recurrent disease that is potentially amenable to salvage therapy with curative intent. Early diagnosis of recurrent disease that can be treated with salvage therapy may lead to better survival.
Abstract
ObjectiveThe objective of this study was to evaluate the clinical benefits of routine squamous cell carcinoma antigen (SCC-Ag) monitoring of patients with locally advanced cervical squamous cell carcinoma treated with radiation or chemoradiation. MethodsA total of 53 patients with recurrent cervical squamous cell carcinoma treated with radiotherapy or chemoradiation were enrolled in this study. A retrospective review of medical records was conducted. The role of routine monitoring of serum SCC-Ag was evaluated in terms of cost effectiveness and effect on survival after diagnosis of recurrence. ResultsSerum SCC-Ag abnormality (≥2.5 ng/mL) was observed in 62.3% of patients when recurrent disease was diagnosed. The first indicator of relapse was abnormal serum SCC-Ag level in 21 patients (39.6%), 10 of whom had asymptomatic recurrent disease amenable to salvage therapy. Adding SCC-Ag measurement to the basic follow up protocol improved the sensitivity for detecting recurrence (The sensitivity of the basic protocol vs. addition of SCC-Ag: 49.1% vs. 88.7%, P<0.001). Twenty-three patients who were candidates for salvage therapy with curative intent showed better survival compared with those who were not candidates for therapy (5-year survival: 36.6% vs. 0%, P=0.012). ConclusionSurveillance with routine serum SCC-Ag monitoring can better detect asymptomatic recurrent disease that is potentially amenable to salvage therapy with curative intent. Early diagnosis of recurrent disease that can be treated with salvage therapy may lead to better survival.
참고문헌 (31)
- Aggarwal P, "Cervical cancer: can it be prevented?", World J Clin Oncol, 5, pp.775~780 (2014)
- Zanagnolo V, "Surveillance procedures for patients with cervical carcinoma : a review of the literature", Int J Gynecol Cancer, 19, pp.194~201 (2009)
- Salani R, "Posttreatment surveillance and diagnosis of recurrence in women with gynecologic malignancies : Society of Gynecologic Oncologists recommendations", Am J Obstet Gynecol, 204, pp.466~478 (2011)
- Gadducci A, "The serum assay of tumour markers in the prognostic evaluation, treatment monitoring and follow-up of patients with cervical cancer: a review of the literature", Crit Rev Oncol Hematol, 66, pp.10~20 (2008)
- Jao MS, "Long-term follow up of cervical cancer patients with unexplained squamous cell carcinoma antigen elevation after post-therapy surveillance using positron emission tomography", J Obstet Gynaecol Res, 36, pp.1003~1008 (2010)
- Reesink-Peters N, "Preoperative serum squamous cell carcinoma antigen levels in clinical decision making for patients with early-stage cervical cancer", J Clin Oncol, 23, pp.1455~1462 (2005)
- Brioschi PA, "Squamouscell carcinoma antigen(SCC-A)values related to clinical outcome of pre-invasive and invasive cervical carcinoma", Int J Cancer, 47, pp.376~379 (1991)
- Micke O, "The im pact of squamous cell carcinoma (SCC) antigen in patients with advanced cancer of uterine cervix treated with (chemo-)radiotherapy", Anticancer Res, 25(3A), pp.1663~1666 (2005)
- Micke O, "The impact of squamous cell carcinoma (SCC) antigen in the follow-up after radiotherapy in patients with cervical cancer", Anticancer Res, 20(6D), pp.5113~5115 (2000)
- Hong JH, "The prognostic significance of pre-and posttreatment SCC levels in patients with squamous cell carcinoma of the cervix treated by radiotherapy", Int J Radiat Oncol Biol Phys, 41, pp.823~830 (1998)
- Bolli JA, "Squamous cell carcinoma antigen : clinical utility in squamous cell carcinoma of the uterine cervix", Gynecol Oncol, 55, pp.169~173 (1994)
- Esajas MD, "Clinical value of routine serum squamous cell carcinoma antigen in follow-up of patients with early-stage cervical cancer", J Clin Oncol, 19, pp.3960~3966 (2001)
- Zola P, "Follow-up in gynecological malignancies : a state of art", Int J Gynecol Cancer, 25, pp.1151~1164 (2015)
- Chan YM, "Monitoring of serum squamous cell carcinoma antigen levels in invasive cervical cancer: is it cost-effective?", Gynecol Oncol, 84, pp.7~11 (2002)
- Lee YS, "Feasibility and outcome of concurrent chemoradiotherapy for recurrent cervical carcinoma after initial surgery", Tumori, 96, pp.553~559 (2010)
- Berek JS, "Pelvic exenteration for recurrent gynecologic malignancy: survival and morbidity analysis of the 45-year experience at UCLA", Gynecol Oncol, 99, pp.153~159 (2005)
- Maneo A, "Radical hysterectomy for recurrent or persistent cervical cancer following radiation therapy", Int J Gynecol Cancer, 9, pp.295~301 (1999)
- Chou HH, "Isolated paraaortic lymph node recurrence after definitive irradiation for cervical carcinoma", Int J Radiat Oncol Biol Phys, 51, pp.442~448 (2001)
- Coleman RL, "Radical hysterectomy for recurrent carcinoma of the uterine cervix after radiotherapy", Gynecol Oncol, 55, pp.29~35 (1994)
- Kim JS, "Hyperfractionated radiotherapy with concurrent chemotherapy for paraaortic lymph node recurrence in carcinoma of the cervix", Int J Radiat Oncol Biol Phys, 55, pp.1247~1253 (2003)
- Ogino I, "The curative role of radiotherapy in patients with isolated para-aortic node recurrence from cervical cancer and value of squamous cell carcinoma antigen for early detection", Int J Gynecol Cancer, 15, pp.630~638 (2005)
- Singh AK, "Cervix carcinoma, concurrent chemoradiotherapy, and salvage of isolated paraaortic lymph node recurrence", Int J Radiat Oncol Biol Phys, 61, pp.450~455 (2005)
- Anraku M, "Pulmonary metastases from uterine malignancies : results of surgical resection in 133 patients", J Thorac Cardiovasc Surg, 127, pp.1107~1112 (2004)
- 기은영, "A Clinicopathological Review of Pulmonary Metastasis from Uterine Cervical Cancer", Cancer Research and Treatment, 48(1), pp.266~272 (2016), 대한암학회[DOI]
- Kainz C, "Cytokeratin subunit 19 measured by CYFRA 21-1 assay in follow-up of cervical cancer", Gynecol Oncol, 56, pp.402~405 (1995)
- Forni F, "Squamous cell carcinoma antigen in follow-up of cervical cancer treated with radiotherapy : evaluation of cost-effectiveness", Int J Radiat Oncol Biol Phys, 69, pp.1145~1149 (2007)
- Kotaro Shimura, "Utility of serum squamous cell carcinoma antigen levels at the time of recurrent cervical cancer diagnosis in determining the optimal treatment choice", Journal of Gynecologic Oncology, 24(4), pp.321~329 (2013), 대한부인종양학회
- Brooks RA, "Surveillance FDG-PET detection of asymptomatic recurrences in patients with cervical cancer", Gynecol Oncol, 112, pp.104~109 (2009)
- Chang TC, "Positron emission tomography for unexplained elevation of serum squamous cell carcinoma antigen levels during follow-up for patients with cervical malignancies : a phase II study", Cancer, 101, pp.164~171 (2004)
- Chung HH, "Clinical impact of integrated PET", CT on the management of suspected cervical cancer recurrence, 2007, pp.104, 529~534
- Siva S, "Impact of post-therapy positron emission tomography on prognostic stratification and surveillance after chemoradiotherapy for cervical cancer", Cancer, 117, pp.3981~3988 (2011)