SERUM LEVEL OF SQUAMOUS-CELL CARCINOMA ANTIGEN AND TUMOR SIZE ARE USEFUL TO IDENTIFY PREOPERATIVELY PATIENTS AT HIGH-RISK OF CERVICAL-CANCER

Background. The benefit of postoperative adjuvant therapy for patients with cervical cancer is uncertain, and moreover, may increase morbidi ty. In this study, patient age, clinical stage of the cancer, tumor si ze, and levels of serum squamous cell carcinoma cell antigen and carci noembryonic antigen were studied in patients with Stage Ib and IIa squ amous cell carcinoma of the uterine cervix to determine if these param eters can be used, before the surgical intervention, to distinguish pa tients who require postoperative adjuvant therapy from those who do no t. Methods. Ninety-nine patients were studied. After surgery, patients were classified either as high risk or low risk according to the resu lts of histopathologic findings. The age of the patient was noted, and FIGO stage, squamous cell carcinoma antigen, carcinoembryonic antigen , and clinical tumor size were determined. A univariate analysis and t hen a stepwise logistic regression procedure were performed to select significant clinical predictors from among the five variables mentione d above. Any selected predictors were further analyzed by the receiver operator characteristic curve. Results. Serum squamous cell carcinoma antigen and clinical tumor size measured by colposcopic examination w ere significant clinical predictors of the treatment strategy postoper atively. From the receiver operator characteristic curve, a sensitivit y of 84.2%, a specificity of 91.8%, a positive predictive value of 84. 5% were attained. Conclusions. Serum squamous cell carcinoma antigen a ssays and clinical tumor size estimated by colposcopic examination are helpful in identifying patients who require postoperative adjunctive therapy.