The prognostic value of squamous cell carcinoma antigen for predicting tumor recurrence in cervical squamous cell carcinoma patients
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Objective The aim of this study was to evaluate the prognostic value of squamous cell carcinoma antigen (SCC-Ag) and theoptimal cut-off value for predicting recurrence in cervical squamous cell carcinoma patients with complete remissionafter primary treatment. Methods We reviewed the records of 783 cervical squamous cell cancer patients who underwent primary therapy and showedcomplete remission at our institution between January 2000 and April 2014. A receiver operating characteristic curvewas used to determine the optimal SCC-Ag threshold to predict recurrence. Cox regression model for disease freesurvival was used to assess differences in outcome. Results The median follow-up period was 41.2 months, and 154 patients (19.7%) had recurrent disease. The medianpretreatment and posttreatment SCC-Ag level was 2.6 ng/mL (range, 0.1 to 532.0 ng/mL) and 0.7 ng/mL (range, 0.0 to46.8 ng/mL), respectively. Both pretreatment and posttreatment SCC-Ag levels were higher in the recurrence group(P=0.017 and P=0.039). Optimal cut-off value of pretreatment and posttreatment SCC-Ag for predicting recurrence was1.86 ng/mL (area under the curve, 0.663; P=0.000), and 0.9 ng/mL (area under the curve, 0.581; P=0.002), respectively. Inthe multivariate Cox regression model, pretreatment SCC-Ag >1.86 ng/mL (odds ratio, 2.11; 95% confidence interval,1.38 to 3.22; P=0.001) and posttreatment SCC-Ag >0.9 ng/mL (odds ratio, 1.64; 95% confidence interval, 1.18 to 2.28;P=0.003) were significantly associated with poor disease free survival. Conclusion Patients with pretreatment SCC-Ag >1.86 ng/mL or posttreatment SCC-Ag >0.9 ng/mL should be considered at high riskfor cancer recurrence after complete remission, and therefore, closer surveillance is needed.
Abstract
Objective The aim of this study was to evaluate the prognostic value of squamous cell carcinoma antigen (SCC-Ag) and theoptimal cut-off value for predicting recurrence in cervical squamous cell carcinoma patients with complete remissionafter primary treatment. Methods We reviewed the records of 783 cervical squamous cell cancer patients who underwent primary therapy and showedcomplete remission at our institution between January 2000 and April 2014. A receiver operating characteristic curvewas used to determine the optimal SCC-Ag threshold to predict recurrence. Cox regression model for disease freesurvival was used to assess differences in outcome. Results The median follow-up period was 41.2 months, and 154 patients (19.7%) had recurrent disease. The medianpretreatment and posttreatment SCC-Ag level was 2.6 ng/mL (range, 0.1 to 532.0 ng/mL) and 0.7 ng/mL (range, 0.0 to46.8 ng/mL), respectively. Both pretreatment and posttreatment SCC-Ag levels were higher in the recurrence group(P=0.017 and P=0.039). Optimal cut-off value of pretreatment and posttreatment SCC-Ag for predicting recurrence was1.86 ng/mL (area under the curve, 0.663; P=0.000), and 0.9 ng/mL (area under the curve, 0.581; P=0.002), respectively. Inthe multivariate Cox regression model, pretreatment SCC-Ag >1.86 ng/mL (odds ratio, 2.11; 95% confidence interval,1.38 to 3.22; P=0.001) and posttreatment SCC-Ag >0.9 ng/mL (odds ratio, 1.64; 95% confidence interval, 1.18 to 2.28;P=0.003) were significantly associated with poor disease free survival. Conclusion Patients with pretreatment SCC-Ag >1.86 ng/mL or posttreatment SCC-Ag >0.9 ng/mL should be considered at high riskfor cancer recurrence after complete remission, and therefore, closer surveillance is needed.
참고문헌 (30)
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