Preoperative SCC-Ag as a predictive marker for the use of adjuvant chemotherapy in cervical squamous cell carcinoma with intermediate-risk factors

Abstract

Background: For cervical cancer patients whose tumors display a combination of intermediate risk factors, postoperative radiation with or without adjuvant chemotherapy is suggested for them. However, who should be administered with adjuvant chemotherapy is unknown. The current study was designed to explore the clinical value of squamous cell carcinoma antigen (SCC-Ag) in guiding the use of adjuvant chemotherapy in cervical cancer patients. Methods: A total of 301 cervical cancer patients were included in the present study from March 2006 to March 2016. There were 156 patents who received adjuvant chemotherapy, while the rest of 145 patents did not receive it. The survival analysis including Overall survival (OS) and disease-free survival (DFS) was assessed by using the Kaplan-Meier method. Cox proportional hazards regression was done to detect factors in predicting the tumor prognosis. Results: In patients with high pre-treatment SCC-Ag level, those who received adjuvant chemotherapy acquired better prognosis than patients who did not receive it. Particularly, a lower rate of distant metastasis was found in the group of adjuvant chemo-radiotherapy than that in the group of adjuvant radiotherapy. As for patients with low pre-treatment SCC-Ag level, we observed no differences in both the OS and DFS between patients who were given and not given with adjuvant chemotherapy. In the multivariable analysis, adjuvant chemotherapy was significantly correlated with DFS and distant metastasis-free survival (DMFS) in patients with high SCC-Ag level. Conclusion: Preoperative SCC-Ag can be a predictive marker for the use of adjuvant chemotherapy in cervical squamous cell carcinoma with intermediate-risk factors.

Novel biomarkers with promising benefits for diagnosis of cervical neoplasia: a systematic review

“…It is present at high levels in 20–60% of patients with early stage cervical cancer (CC), with abnormally high levels also observed in 25% of individuals with adenocarcinoma (ADC) [ 7 ]. Recent studies have established that elevated levels of SCC-Ag is associated with extensive tumor, poor survival of patients treated by CCRT, and radiotherapy resistance [ 71 , 73 ]; and that, preoperative SCC-Ag is equally useful in predicting adjuvant chemotherapy outcome in patients with intermediate-risk factors [ 74 ]. Unfortunately, few studies have evaluated the performance of SCC-Ag assay, either as single biomarker or in combination with other complementary biomarkers; thus, calling for more robust clinical translation studies with larger consecutive cohorts of women participants.…”

Associations of whole-body 18F-FDG PET/CT parameters and SCC-Ag level with overall survival in patients with cervical cancer

“…Elevated expression of SCC-Ag is associated with shorter overall survival (OS) and a higher rate of metastasis [3]. Many studies have shown that the SCC-Ag level is an important prognostic factor for cervical SCC, which can guide the development of a more active treatment plan [3,12,13]. In this study, the prognostic value for post-treatment cervical SCC was evaluated using a combination of 18 F-FDG PET/CT whole-body metabolic tumour load and SCC-Ag level.…”