The prognostic value of the tumour marker Cyfra 21-1 in carcinoma of head and neck and its role in early detection of recurrent disease

This study examines a new tumour marker, Cyfra 21-1, as a prognostic marker in predicting the survival of H&N cancer patients, and its correlation wit h clinical outcome during prolonged follow up of these patients. The study included 67 patients with primary detection of carcinoma of H&N. The surviv al of these patients was evaluated in correlation with the disease stage an d Cyfra 21-1 levels at initial diagnosis. 38 patients were followed clinica lly and with serial assays for at least 12 months. or until recurrence was diagnosed. Cyfra 21-1 levels were determined periodically, using an Elisa k it. Patients with Cyfra 21-1 < 1.5 ng ml(-1) had a higher survival rate com pared to patients with Cyfra 21-1 <greater than or equal to> 1.5 ng ml(-1) (63% vs. 20%, respectively). The risk ratio of Ln(Cyfra 21-1) is 1.62 (P = 0.028). In a Cox regression model that included the disease stage and Ln(Cy fra 21-1), Ln(Cyfra 21-1) was preferred as the main parameter for predictin g patients survival. In 83% of the 12 patients with recurrent or residual d isease. Cyfra 21-1 was elevated before or during clinical detection of the recurrence. Cyfra 21-1 was found to be a prognostic marker for carcinoma of H&N, unrelated to the stage of the disease. Elevated levels of Cyfra 21-1 without clinical evidence of disease can be attributed to the marker's mean lead-time as compared to the clinical appearance of the disease. (C) 2000 Cancer Research Campaign.