MULTIPLE TUMOR-MARKER ASSAYS IN ADVANCED CERVICAL-CANCER - RELATIONSHIP TO CHEMOTHERAPY RESPONSE AND CLINICAL OUTCOME

Serum levels of squamous cell carcinoma antigen (SCC), CA 125 and CA 1 5.3 were measured in 102 patients with locally advanced cervical cance r undergoing neoadjuvant chemotherapy (NACT) and radical surgery. We f ound a significant correlation between SCC concentration and stage, hi stotype, cervical tumour size and lymph node status. For CA 125 and CA 15.3, no significant difference in the distribution of marker levels according to histopathological variables was found. In a multivariate analysis, histological type, FIGO stage and SCC positivity (>5 ng/ml) proved to be independent predictors of response to neoadjuvant chemoth erapy. Moreover, logistic regression analysis showed that CA 15.3 may be a significant adjunct to SCC in the prediction of chemotherapy resp onse. Of the three markers tested, only CA 125 was significantly relat ed to patient survival. In the multivariate analysis, clinical respons e to chemotherapy and CA 125 status (>35 U/ml) retained an independent prognostic value. Our data suggest that the tumour markers used in th is study could be useful in the management of locally advanced cervica l cancer. Pretreatment serum levels of SCC, together with CA 15.3 assa y, may be a useful tool in the determination of response to chemothera py, while CA 125 assay could be evaluated as a prognostic risk factor in these patients.