SQUAMOUS-CELL CARCINOMA ANTIGEN - PROGNOSTIC-SIGNIFICANCE AND ROLE INTHE MONITORING OF NEOADJUVANT CHEMOTHERAPY RESPONSE IN CERVICAL-CANCER

Purpose: The aim of the study was to investigate the role of squamous cell carcinoma antigen (SCC) in the management of patients with locall y advanced cervical cancer treated by neoadjuvant chemotherapy and rad ical surgery. Patients and Methods: SCC assay was performed with a rad ioimmunoassay kit in a series of 102 patients with locally advanced ce rvical cancer. The values of 2.5, 5, and 7 ng/mL were used to define S CC antigen positivity. The chi(2) and Fisher's exact test and the step wise logistic regression were used to evaluate the distribution of mar ker valves. Analysis of survival was performed using the Kaplan and Me ier test and Cox multivariate regression analysis. Results: SCC levels were elevated in 65%, 45%, and 32% of patients with primary tumors fo r cutoff values of 2.5, 5, and 7 ng/mL, respectively. SCC pretreatment levels correlated with stage, tumor volume and lymph node status. In the multivariate analysis, SCC expression proved to be an independent predictor of response to neoadjuvant chemotherapy. SCC posttreatment l evels were strongly related to chemotherapy response. Moreover, the ov erall correlation between the clinical course of the disease and the v ariation of SCC levels was 83%. In patients with squamous cell tumors, survival was significantly longer in SCC-negative cases compared with SCC-positive cases (P = .04). Moreover, in patients undergoing surger y after response to neoadjuvant chemotherapy, low SCC values were asso ciated with better prognosis (P = .02). In the multivariate analysis, parametrial involvement and SCC status proved to retain an independent prognostic value. Conclusion: Our data show that SCC assay may provid e useful information to improve the prognostic characterization and di sease monitoring of patients with locally advanced cervical cancer und ergoing neoadjuvant chemotherapy. (C) 1994 by American Society of Clin ical Oncology.