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The curative role of radiotherapy in patients with isolated para-aortic node recurrence from cervical cancer and value of squamous cell carcinoma antigen for early detection
  1. I. Ogino*,
  2. H. Nakayama,
  3. T. Kitamura,
  4. N. Okamoto§ and
  5. T. Inoue*
  1. * Department of Radiology, Yokohama City University, Yokohama, Japan
  2. Department of Gynecology, Kanagawa Cancer Center, Yokohama, Japan
  3. Department of Radiation Oncology, Kanagawa Cancer Center, Yokohama, Japan
  4. § Department of Epidemiology, Kanagawa Cancer Center, Yokohama, Japan
  1. Address correspondence and reprint requests to: Ichiro Ogino, MD, Department of Radiology, School of Medicine, Yokohama City University, 3-9 Fukuura, Kanazawa-ku, Yokohama 236-0004, Japan. Email: oginoro{at}


The objective of this study was to examine the clinical benefits of routine squamous cell carcinoma antigen (SCC-ag) monitoring of patients with locally advanced cervical cancer. Recurrent disease occurred in 99 uterine cervical cancer patients with elevated pretreatment SCC-ag before primary radiotherapy. Elevated SCC-ag levels persisted in 23 patients after primary radiotherapy (group 1), and SCC-ag was normalized in 76 patients after primary radiotherapy (group 2). The overall survival (OS) rate was higher for patients with SCC-ag elevation as the first sign than for patients with recurrence predicted by other modalities for group 2 patients (P = 0.033). The prediction of isolated para-aortic node recurrence significantly correlated with SCC-ag elevation as an initial sign (P = 0.001). The SCC-ag level before primary radiotherapy (≥10.8 ng/mL) significantly affected recurrence predicted by SCC-ag elevation as an initial sign (P = 0.002). For multivariate analysis, the presence of para-aortic node recurrence was statistically significant in OS (P < 0.0001). Routine SCC-ag monitoring of patients with carcinoma of the uterine cervix can lead to the early diagnosis of isolated para-aortic lymph node recurrence, and prolonged survival can be achieved by applying radiation therapy to the para-aortic region. To reduce the number of patients monitored for SCC-ag, we recommend monitoring group 2 patients with pretreatment SCC-ag level before primary radiotherapy ≥10.8 ng/mL.

  • cervical carcinoma
  • isolated para-aortic lymph node recurrence
  • squamous cell carcinoma antigen

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