POSTTREATMENT SERIAL SERUM SQUAMOUS-CELL CARCINOMA ANTIGEN (SCC) IN THE MONITORING OF SQUAMOUS-CELL CARCINOMA OF THE CERVIX

Serum squamous cell carcinoma antigen (SCC) was raised in 62% of 308 p atients with squamous cell carcinoma of the cervix before treatment. P ost-treatment SCC levels were raised in 69 patients (22.4%). Retrospec tive review showed that persistently raised SCC level after treatment was significantly associated with persistent or recurrent disease in s quamous cell carcinoma of the cervix. The specificity of persistently raised SCC level in association with recurrent disease was 98.2%. The sensitivity in association with recurrent disease was 74.7%. The posit ive predictive values was 94.2%. The median lead time for recurrence w as 4 months. SCC was raised in 38% of patients with clinical evidence of disease in the vagina. One patient had raised SCC one month prior t o clinical detection of vaginal metastasis and was salvaged by an exen terative procedure. SCC was raised in 71-91% of patients with metastat ic disease in the lung, lymph nodes or other distant sites. Thus, pers istently raised SCC level after treatment of squamous cell carcinoma s hould alert the clinician to look for recurrent disease especially in distant metastatic sites. Past-treatment raised SCC level was associat ed with less than 5% 5-year survival rate whereas in patients with nor mal SCC level, the 5-year survival rate was 87%.