RT Journal Article
SR Electronic
T1 Accuracy of surveillance serum squamous cell carcinoma antigen for cervical cancer recurrence after definitive chemoradiation
JF International Journal of Gynecologic Cancer
JO Int J Gynecol Cancer
FD BMJ Publishing Group Ltd
SP 808
OP 816
DO 10.1136/ijgc-2024-005303
VO 34
IS 6
A1 Shi, Victoria
A1 Grover, Surbhi
A1 Huang, Yi
A1 Thaker, Premal H
A1 Kuroki, Lindsay M
A1 Powell, Matthew A
A1 Mutch, David G
A1 Contreras, Jessika A
A1 Schwarz, Julie K
A1 Grigsby, Perry W
A1 Markovina, Stephanie
YR 2024
UL http://ijgc.bmj.com/content/34/6/808.abstract
AB Objective Recurrence remains a significant clinical problem for patients with cervical cancer, and early detection may improve outcomes. Serum squamous cell carcinoma antigen (SCCA) is a biomarker of prognosis and response to chemoradiotherapy. We hypothesized that elevated serum SCCA during surveillance is sensitive and specific for recurrence.Methods Pre-treatment and follow-up serum SCCA from patients treated with definitive-intent radiotherapy were measured via enzyme-linked immunosorbent assay in a Clinical Laboratory Improvement Amendments (CLIA)-certified laboratory and analyzed retrospectively. Follow-up SCCA was defined as the value closest to recurrence, or as last available for patients without recurrence. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of follow-up SCCA for recurrence was determined for the whole cohort (Cohort 1), for patients with elevated (Cohort 2), and normal pre-treatment SCCA (Cohort 3). Patterns of failure were also evaluated.Results Of 227 patients in Cohort 1, 23% experienced recurrence, and 17% died of cervical cancer. Mean follow-up SCCA was 0.9 (±2.5) for patients with no recurrence and 6.0 (±18.7) for patients with recurrence (p=0.02). Sensitivity, specificity, PPV, and NPV of follow-up SCCA for recurrence in Cohort 1 were 38.5%, 97.1%, 80%, and 84.2%, and for patients in Cohort 2 were 54.5%, 95%, 78.3%, and 86.5%, respectively. Four of 86 patients in Cohort 3 had an elevated follow-up SCCA, two of these at the time of recurrence. Elevated pre-treatment SCCA and follow-up SCCA were associated with isolated pelvic recurrence.Conclusions Surveillance serum SCCA has high specificity and NPV for recurrence, and may be of limited utility in patients with normal pre-treatment SCCA.Data are available upon reasonable request. The data used for this analysis may be available upon request in an anonymized way that is compliant with the Health Insurance Portability and Accountability Act of 1996 (HIPAA) and institutional practice under a data-sharing agreement. Only de-identified aggregated data will be provided.