Clinical Value of Routine Serum Squamous Cell Carcinoma Antigen in Follow-Up of Patients With Early-Stage Cervical Cancer

• Published in: Journal of clinical oncology Vol. 19; no. 19; pp. 3960 - 3966
• Main Authors: ESAJAS, Martha D, DUK, Jitze M, DE BRUIJN, Henk W. A, AALDERS, Jan G, WILLEMSE, Pax H. B, SLUITER, Wim, PRAS, Betty, TEN HOOR, Klaske, HOLLEMA, Harry, VAN DER ZEE, Ate G. J
• Format: Journal Article
• Language: English
• Published: Baltimore, MD American Society of Clinical Oncology 01.10.2001; Lippincott Williams & Wilkins
• Subjects: Antigens, Neoplasm - blood; Biological and medical sciences; Biomarkers, Tumor - blood; Carcinoma, Squamous Cell - immunology; Carcinoma, Squamous Cell - pathology; Carcinoma, Squamous Cell - radiotherapy; Carcinoma, Squamous Cell - surgery; Female; Female genital diseases; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Medical sciences; Neoplasm Recurrence, Local - immunology; Serpins; Tumors; Uterine Cervical Neoplasms - immunology; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - radiotherapy; Uterine Cervical Neoplasms - surgery; Human; Relapse; Prognosis; Tumor associated antigen; Early stage; Tumoral marker; Uterine cervix; Malignant tumor; Female genital diseases; Surveillance; Serum; Diagnosis; Uterine cervix diseases
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2001.19.19.3960

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. 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. 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. 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.