Prognostic Value of Preoperative Squamous Cell Carcinoma Antigen Level in Patients Surgically Treated for Cervical Carcinoma

• Published in: Gynecologic oncology 1997-05, Vol.65 (2), p.309-313
• Main Authors: Bolger, B.S., Dabbas, M., Lopes, A., Monaghan, J.M.
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - blood; Adenocarcinoma - mortality; Adenocarcinoma - secondary; Adult; Antigens, Neoplasm - blood; Biological and medical sciences; Biomarkers, Tumor - blood; Carcinoma, Adenosquamous - blood; Carcinoma, Adenosquamous - mortality; Carcinoma, Adenosquamous - secondary; Carcinoma, Squamous Cell - blood; Carcinoma, Squamous Cell - mortality; Carcinoma, Squamous Cell - secondary; Female; Female genital diseases; Follow-Up Studies; Gynecology. Andrology. Obstetrics; Humans; Lymphatic Metastasis; Medical sciences; Middle Aged; Neoplasm Recurrence, Local - blood; Neoplasm Recurrence, Local - epidemiology; Predictive Value of Tests; Preoperative Care; Prognosis; Serpins; Survival Rate; Tumors; Uterine Cervical Neoplasms - blood; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - surgery
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1006/gyno.1997.4619

Preoperative evaluation of squamous cell carcinoma antigen (SCCa) was performed in 220 patients with surgically treated early-stage carcinoma of the cervix. The median duration of follow-up was 1.9 years. SCCa was significantly higher in tumors with a squamous element (P< 0.001). There was a squamous element in 171 tumors. SCCa was elevated (>2 ng/ml) in 21.6%. Significantly higher levels were associated with stage II disease (P< 0.001), tumors >4-cm size (P< 0.001), and lymph node metastases (P< 0.001). The positive predictive value for lymph node metastases at >2, >4, and >8.6 ng/ml SCCa is 51.4, 70.0, and 100% and the sensitivity is 58.1, 45.2, and 22.6%, respectively. Low SCCa is a poor predictor of absence of lymph node metastasis. The median SCCa for patients who developed tumor recurrence was greater than those who remained disease free (1.7 and 1.0 ng/ml, respectively,P= 0.009); however, in a multivariate analysis only lymph node metastasis and tumor size were of independent prognostic significance (P= 0.002 andP= 0.004, respectively). SCCa level >8.6 ng/ml is highly predictive of lymph nodal disease. There is no independent prognostic significance in patients with early-stage surgically treated cervical carcinoma.