Abstract
ObjectiveTo evaluate the prognostic effects of combining serum circulating tumor cells (CTCs) and squamous cell carcinoma antigen (SCC-Ag) levels on patients with locally advanced cervical cancer treated with radiotherapy.MethodsNinety-nine patients with locally advanced cervical cancer ([FIGO] stage IIB-IVA) undergoing radiotherapy (RT) or concurrent chemoradiotherapy (CCRT) were identified. The association between serum CTC level and clinicopathological parameters was examined. Univariate and multivariate survival analyses were performed by using Cox’s proportional hazards regression model.ResultsElevated CTC and SCC-Ag levels were significantly associated with poor disease-free survival (DFS). Multivariate analysis suggest that serum CTC level, FIGO stage and serum SCC-Ag level were independent prognostic factors for two-year DFS. When CTC and SCC-Ag levels were combined into a new risk model to predict disease progression of cervical cancer patients, it performed a significantly better predictive efficiency compared with either biomarker alone.ConclusionSerum CTC and SCC-Ag levels are potentially useful biomarkers for prediction of prognosis in locally advanced cervical cancer patients and their combination significantly improves predictive ability for survival in locally advanced cervical cancer patients.
Highlights
According to a recently published study by the GLOBOCAN on the research of cancer, cervical cancer is the fourth most common cancer in women, with approximately 266,000 cancerrelated deaths worldwide in 2012[1]
Elevated circulating tumor cells (CTCs) and Squamous cell carcinoma antigen (SCC-Ag) levels were significantly associated with poor disease-free survival (DFS)
Multivariate analysis suggest that serum CTC level, FIGO stage and serum SCC-Ag level were independent prognostic factors for two-year DFS
Summary
According to a recently published study by the GLOBOCAN on the research of cancer, cervical cancer is the fourth most common cancer in women, with approximately 266,000 cancerrelated deaths worldwide in 2012[1]. Concurrent chemoradiotherapy (CCRT) has become the primary treatment modality for the patients with International Federation of Gynecology and Obstetrics [FIGO] stage IIB-IVA cervical cancer based on the encouraging results from several randomized trials published in 1999[2,3,4,5]. It is significantly important to identify prognostic factors in patients with locally advanced cervical cancer treated with RT or CCRT. Squamous cell carcinoma antigen (SCC-Ag) is the most widely used and reliable tumor marker for the diagnosis[9], monitoring[10]and prediction of cervical cancer prognosis[7]. Several high-risk factors in clinical practice, including advanced stage, bulky tumor size, positive pelvic lymph node metastasis, and high serum SCC-Ag levels were found to be associated with poor prognosis in cervical cancer patients[11]. We sought to identify additional markers that could complement SCC
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