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Clinical value of routine serum squamous cell carcinoma antigen in follow-up of patients with locally advanced cervical cancer treated with radiation or chemoradiation

대한산부인과학회지
2016년 59권 4호 p.269 ~ p.278
 ( Oh Jin-Ju ) - Catholic University of Daegu School of Medicine Department of Obstetrics and Gynecology

 ( Lee Hyun-Joo ) - Catholic University of Daegu School of Medicine Department of Obstetrics and Gynecology
 ( Lee Tae-Sung ) - Catholic University of Daegu School of Medicine Department of Obstetrics and Gynecology
 ( Kim Ju-Hyun ) - Catholic University of Daegu School of Medicine Department of Obstetrics and Gynecology
 ( Koh Suk-Bong ) - Catholic University of Daegu School of Medicine Department of Obstetrics and Gynecology
 ( Choi Youn-Seok ) - Catholic University of Daegu School of Medicine Department of Obstetrics and Gynecology

Abstract

Objective: The objective of this study was to evaluate the clinical benefits of routine squamous cell carcinoma antigen (SCC-Ag) monitoring of patients with locally advanced cervical squamous cell carcinoma treated with radiation or chemoradiation.

Methods: A total of 53 patients with recurrent cervical squamous cell carcinoma treated with radiotherapy or chemoradiation were enrolled in this study. A retrospective review of medical records was conducted. The role of routine monitoring of serum SCC-Ag was evaluated in terms of cost effectiveness and effect on survival after diagnosis of recurrence.

Results: Serum SCC-Ag abnormality (≥2.5 ng/mL) was observed in 62.3% of patients when recurrent disease was diagnosed. The first indicator of relapse was abnormal serum SCC-Ag level in 21 patients (39.6%), 10 of whom had asymptomatic recurrent disease amenable to salvage therapy. Adding SCC-Ag measurement to the basic follow up protocol improved the sensitivity for detecting recurrence (The sensitivity of the basic protocol vs. addition of SCC-Ag: 49.1% vs. 88.7%, P<0.001). Twenty-three patients who were candidates for salvage therapy with curative intent showed better survival compared with those who were not candidates for therapy (5-year survival: 36.6% vs. 0%, P=0.012).

Conclusion: Surveillance with routine serum SCC-Ag monitoring can better detect asymptomatic recurrent disease that is potentially amenable to salvage therapy with curative intent. Early diagnosis of recurrent disease that can be treated with salvage therapy may lead to better survival.

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학술진흥재단(KCI) KoreaMed 대한의학회 회원 
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