Abstract
BackgroundOur aim was to investigate the value of serum squamous cell carcinoma (SCC) antigen levels in predicting chemosensitivity, lymph node metastasis, as well as prognosis in patients with cervical squamous cell carcinoma who received neoadjuvant chemotherapy (NACT).MethodsThis retrospective study enrolled 103 patients with cervical squamous cell carcinoma and then compared the SCC antigen levels between patients who underwent NACT followed by radical surgery (NACT group) and those who underwent radical surgery alone (conventional group), and a correlation analysis between SCC antigen levels and chemosensitivity, lymph node metastasis, or survival time was conducted.ResultsThe SCC antigen levels changed after NACT and were associated with chemosensitivity. Moreover, the optimal cut-off value of the percentage decrease in SCC antigen level after the first chemotherapy (FSCC (%)) was 42.0%, which could be used for assessment of chemosensitivity. The rate of positive lymph nodes in patients with pretreatment SCC antigen levels ≥3.9 ng/mL was significantly decreased after NACT. The overall survival (OS) of NACT group was significantly longer than that of conventional group when the pretreatment SCC antigen levels were ≥ 4.55 ng/mL. The OS and progression-free survival rates of patients with SCC antigen levels < 2.7 ng/mL were longer than those ≥2.7 ng/mL after the first chemotherapy.ConclusionsThe 42.0% of FSCC (%) after NACT is a reliable indicator of chemosensitivity. Pretreatment and posttreatment SCC antigen levels can be used in evaluating the lymph node metastases and prognosis of patients with cervical squamous cell carcinoma.
Highlights
Our aim was to investigate the value of serum squamous cell carcinoma (SCC) antigen levels in predicting chemosensitivity, lymph node metastasis, as well as prognosis in patients with cervical squamous cell carcinoma who received neoadjuvant chemotherapy (NACT)
In accordance with the Response Evaluation Criteria in Solid Tumors guideline, the tumor response to NACT in 1, 30, 32, and 1 patient in the NACT group was defined as complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD), respectively
31 patients were divided into the chemotherapy-sensitive group, and 33 patients were assigned into the chemotherapy-insensitive group
Summary
Our aim was to investigate the value of serum squamous cell carcinoma (SCC) antigen levels in predicting chemosensitivity, lymph node metastasis, as well as prognosis in patients with cervical squamous cell carcinoma who received neoadjuvant chemotherapy (NACT). The squamous cell type accounts for > 85% of cervical cancers [3]. The primary treatments for cervical cancer are surgery and chemoradiotherapy. Compared with radical hysterectomy alone, NACT with cisplatin and taxol followed by radical surgery prolongs the disease-free survival of patients with stage II cervical squamous cell carcinoma with a large mass [4]. The National Comprehensive Cancer Center clinical practice guidelines in oncology: cervical cancer (2018.V1) significantly influence the practice of clinicians in providing NACT before surgery due to the lack of references. For patients who choose radical hysterectomy, predicting whether NACT should be applied before surgery and evaluating the efficacy of NACT are the key points for clinicians
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