Prognostic value of tumor measurement parameters and SCC-Ag changes in patients with locally-advanced cervical cancer.

OBJECTIVE

To investigate the prognostic relevance of specific measurement parameters such as tumor diameter, tumor volume, tumor volume reduction rate (TVRR), and changes in the squamous cell carcinoma antigen (SCC-Ag) level in patients with locally-advanced cervical cancer (LACC) undergoing concurrent radiotherapy and chemotherapy.

METHODS

This was a retrospective study of 203 patients with stage IIA-IVA cervical squamous cell carcinoma who were newly diagnosed at our hospital between January 2011 and March 2015. Clinical data and pre-and post-treatment imaging information were collected and each parameter was calculated using 3DSlicer software. The pre/post-treatment tumor diameter (TD), tumor volume (TV), SCC-Ag (SCC), and TVRR, SCC-Ag reduction rate (SCCRR) were analyzed and their prognostic relevance evaluated.

RESULTS

The median follow-up was 69 months. The 5-year overall survival (OS) and disease progression-free survival (PFS) rates were 69.5% and 64.5%, respectively. On univariate analysis, TD, TV, TVRR, SCC and SCCRR showed significant association with OS and PFS (P < 0.05). On multivariate analysis, TD [Hazard ratio (HR) = 0.373, P = 0.028], TD (HR = 0.376, P = 0.003) and SCC (HR = 0.374, P = 0.001) were independent predictors of OS. TVRR (HR = 2.998, P < 0.001), SCC (HR = 0.563, P = 0.041), and SCC (HR = 0.253, P < 0.001) were independent predictors of PFS. Tumor measurement parameters showed a positive correlation with SCC-Ag (P < 0.05).

CONCLUSION

TD, TV, TVRR, SCC, and SCCRR were prognostic factors in LACC. TD and SCC showed the most significant prognostic value. TVRR and SCC were closely related to disease progression. Further studies should investigate the correlation between measurement parameters of tumor and SCC-Ag.