A REAPPRAISAL OF THE SQUAMOUS-CELL CARCINOMA ANTIGEN AS A TUMOR-MARKER IN HEAD AND NECK-CANCER

Objective: To analyze serial measurements of squamous cell carcinoma a ntigen (SCCAg) to determine its prognostic significance in squamous ce ll carcinoma of the head and neck (SCCHN). Design: Retrospective analy sis of serial SCCAg measurements in 75 patients with squamous cell car cinoma of the head and neck. Serum samples were obtained preoperativel y and at postoperative intervals ranging from 1 week to 36 months. Ser um SCCAg levels were determined by radioimmunoassay. Setting: Oncologi c head and neck practice at a tertiary referral hospital. Patients: Tu mor Registry data of 75 consecutive patients with at least three posto perative SCCAg determinations were reviewed to provide equal numbers o f patients with and without recurrent disease. All patients who remain ed disease-free were followed up for at least 2 years. All patients we re previously untreated and underwent surgical therapy. Main Outcome M easures: Association of postoperative SCCAg levels and 2-year disease- free survival. Results: No differences in preoperative levels were not ed, but SCCAg levels predicted 2-year disease-free survival at 6, 9, a nd 12 months after surgery. The ratio of postoperative SCCAg levels to preoperative and early postoperative levels also provided prognostic information. Conclusions: Serial measurements of SCCAg postoperatively in patients with head and neck cancer predict outcome and may allow f or earlier detection of recurrent disease. Further studies are needed to determine if earlier detection can be translated into improved surv ival.