scholarly journals Clinical value of serum biomarkers, squamous cell carcinoma antigen and apolipoprotein C-II in follow-up of patients with locally advanced cervical squamous cell carcinoma treated with radiation: A multicenter prospective cohort study

PLoS ONE ◽  
2021 ◽  
Vol 16 (11) ◽  
pp. e0259235
Author(s):  
Yoko Harima ◽  
Takuro Ariga ◽  
Yuko Kaneyasu ◽  
Hitoshi Ikushima ◽  
Sunao Tokumaru ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Serum Biomarkers ◽  
Rank Test ◽  
Free Survival ◽  
Apolipoprotein C ◽  
Multicenter Prospective Cohort Study ◽  
Multicenter Prospective Cohort

There are currently no reliable, established serum biomarkers to predict the prognosis of radiotherapy for advanced cervical cancer. We aimed to identify serum biomarkers for survival after radiotherapy for cervical cancer. In this multicenter prospective cohort study, the usefulness of pre- and posttreatment serum protein levels of potential biomarkers, including squamous cell carcinoma antigen (SCC-Ag), apolipoprotein C-II (ApoC-II), matrix metalloproteinase (MMP)1, and MMP2, were evaluated together with clinical factors in 145 cervical cancer patients in order to determine their suitability to predict survival. Progression-free survival (PFS) was the primary endpoint, and overall survival (OS), pelvic PFS (PPFS), and distant metastasis-free survival (DMFS) were the secondary endpoints. Blood samples were collected before and 1 month after radiotherapy to measure serum biomarker levels. ApoC-II was measured using a monoclonal antibody-based enzyme-linked immunosorbent assay, which was developed for this purpose. Kaplan-Meier method, log-rank test, and univariate and multivariate Cox proportional hazards models were used for statistical analyses. In multivariate analysis, larger tumor size was independently associated with shorter PFS, OS, PPFS, and DMFS, while longer overall treatment time was independently associated with shorter PPFS. Higher pretreatment SCC-Ag (P < 0.001) was associated with shorter DMFS. Higher posttreatment SCC-Ag (P = 0.017) was also associated with shorter DMFS. Pretreatment ApoC-II was associated with PPFS in univariate analysis (P = 0.048), but not in multivariate analysis. Patients with pretreatment ApoC-II levels ≤ 25.8 μg/ml had shorter PPFS than those with pretreatment ApoC-II levels > 25.8 μg/ml (P = 0.023, log-rank test). Pre- and posttreatment serum SCC-Ag and pretreatment serum ApoC-II levels may be important biomarkers to predict survival outcomes of patients with cervical cancer after radiotherapy. Pre- and posttreatment SCC-Ag and pretreatment ApoC-II might be useful in clinical settings for screening patients to improve treatment strategies in cervical cancer.

scholarly journals Prognostic Impact of Histopathology in Patients with Advanced Stage Cervical Carcinoma Treated with Radiotherapy

2019 ◽  
Vol 37 (4) ◽  
pp. 175-180
Author(s):  
Nasrin Hossain ◽  
Rahana Perveen ◽  
Mohammed Sharif Mahmud ◽  
Mohammed Kabirul Hassan
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Cervical Carcinoma ◽  
Squamous Cell ◽  
Disease Free Survival ◽  
Advanced Stage ◽  
Free Survival ◽  
Histopathological Type ◽  
Disease Free

Introduction: Cervical cancer is the fourth most common cancer in women worldwidev . Most patients in developing countries including Bangladesh present at advanced stage. Histopathological types of cervical cancer influence the treatment outcome when treated by radiation therapy. Objective: To determine the disease free survival (DFS) in different histopathological types in advanced stage cervical carcinoma treated with radiotherapy. Methods: A prospective cohort study was conducted in Gynaecological oncology outpatient department (GOPD) of National institute of Cancer Research & Hospital (NICRH), Dhaka for one year from September’2016 to July’2017. Advanced stage (IIB-IVB) cervical cancer who completed radiation therapy and histopathological type either squamous cell carcinoma or adenocarcinoma of cervix were included in this study. Results: The median follow-up time was 1.82 years; range was 8 to 24 months. Average disease free survival (DFS) was 1.53years in squamous cell carcinoma (SSC) and 1.51 years in adenocarcinoma (ADC). Local recurrences was higher in adenocarcinoma group (62.5%) than squamous cell carcinoma (30.5%) & the difference was statistically significant (p = 0.001). Loco-regional recurrence and distal recurrence were also higher in ADC than SSC but results were not statistically significant (p=.345, p=.795). In multivariate analysis it was shown that histopathological type and stage of disease were found to be independently significant prognostic factors for DFS, hazard ratio were 1.766 (p=.018) and 2.173 (p=.006). Conclusion: Adenocarcinoma was a poor prognostic factor for patients with locally advanced cervical carcinoma. Advanced stage of disease was also significant predictor for disease free survival. J Bangladesh Coll Phys Surg 2019; 37(4): 175-180

scholarly journals Preoperative SCC-Ag as a predictive marker for the use of adjuvant chemotherapy in cervical squamous cell carcinoma with intermediate-risk factors

2020 ◽  
Author(s):  
Hong-tao Guo ◽  
Xue-han Bi ◽  
Ting Lei ◽  
Xiao Lv ◽  
Guang Yao ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Adjuvant Chemotherapy ◽  
Cell Carcinoma ◽  
Cancer Patients ◽  
Squamous Cell ◽  
Distant Metastasis ◽  
Adjuvant Radiotherapy ◽  
Disease Free Survival ◽  
Free Survival

Abstract Background For cervical cancer patients whose tumors display a combination of intermediate risk factors, postoperative radiation with or without adjuvant chemotherapy is suggested for them. However, who should be administered with adjuvant chemotherapy is unknown. The current study was designed to explore the clinical value of squamous cell carcinoma antigen in guiding the use of adjuvant chemotherapy in cervical cancer patients.Methods A retrospective study of 301 cervical cancer patients treated by surgery and adjuvant treatment from Mar. 2005 to Mar. 2015 was performed. All patients were divided into two groups according to receiving adjuvant chemotherapy or not. Overall survival (OS), disease-free survival (DFS) were compare between patients who did and did not receive adjuvant radiotherapy. Multivariate analysis was employed to detect clinical factors associated with disease-free survival, local recurrence-free survival and distant metastasis-free survival.Results For patients with high pre-treatment squamous cell carcinoma level, DFS and OS in adjuvant chemo-radiotherapy group were higher than that in adjuvant radiotherapy group. Besides, the rates of distant metastasis were found lower in patients who did receive adjuvant chemotherapy than those who did not. For patients with upper low pre-treatment squamous cell carcinoma level, the 5-year OS and DFS were similar between groups of adjuvant chemo-radiotherapy and adjuvant radiotherapy. Multivariable analysis indicated adjuvant chemotherapy was independent predictors of DFS and distant metastasis-free survival in patients with high squamous cell carcinoma level.Conclusion Squamous cell carcinoma can serve as an indication for the administration of adjuvant chemotherapy in cervical cancer patients.

Distinctive clinicopathologic characteristics and prognosis for different histologic subtypes of early cervical cancer

2019 ◽  
Vol 29 (8) ◽  
pp. 1244-1251 ◽  
Author(s):  
Lijie Cao ◽  
Hao Wen ◽  
Zheng Feng ◽  
Xiaotian Han ◽  
Xiaohua Wu
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Adenosquamous Carcinoma ◽  
Clinicopathologic Characteristics ◽  
Free Survival ◽  
Early Cervical Cancer ◽  
Histologic Subtypes ◽  
Lymphovascular Space Invasion

ObjectivesTo compare clinicopathologic characteristics and prognosis for different histologic subtypes in early cervical cancer.MethodsPatients who underwent radical surgery for stage IA2–IIA2 cervical cancer with squamous cell carcinoma, adenocarcinoma, or adenosquamous carcinoma between March 2006 and February 2014 at our institution were retrospectively evaluated. The two-sample t-test was used to compare the mean values of continuous variables. The Chi-square test was used to assess differences in the distribution of categorical variables. Survival curves were generated by the Kaplan-Meier method using log-rank test. Univariable and multivariable analyses were performed using Cox regression analysis.ResultsOf 5181 patients evaluated, 4510 had squamous cell carcinoma, 488 had adenocarcinoma, and 183 had adenosquamous carcinoma. Compared with squamous cell carcinoma, adenocarcinoma was associated with earlier stage, smaller tumor size, less lymphovascular space invasion (26.7% vs 37.9%), less deep (>2/3 depth) stromal invasion (30.4% vs 36.2%), and more ovarian metastasis (4.2% vs 0.7%) (all p<0.001). Compared with adenosquamous carcinoma, adenocarcinoma was associated with earlier stage (p=0.011), smaller tumor size (p<0.001), less lymphovascular space invasion (26.7% vs 41.5%, p<0.001), and less peripheral nerve infiltration (5.7% vs 15.4%, p<0.001). Except for more peripheral nerve infiltration in adenosquamous carcinoma (15.4% vs 8.4%, p=0.002), no significant differences in other clinicopathologic characteristics were noted between squamous cell carcinoma and adenosquamous carcinoma. Five-year recurrence-free survival was 85.1%, 78.2%, and 72.3% for squamous cell carcinoma, adenocarcinoma, and adenosquamous carcinoma, respectively (p<0.001). Corresponding 5-year overall survival was 89.7%, 83.1%, and 79.6%, respectively (p<0.001). In multivariable analysis, adenocarcinoma and adenosquamous carcinoma were independent prognostic factors for worse recurrence-free survival for adenocarcinoma versus squamous cell carcinoma (HR 2.594 (95% CI 2.030 to 3.316), p<0.001) and for adenosquamous carcinoma versus squamous cell carcinoma (HR 2.105 (95% CI 1.517 to 2.920), p<0.001), and overall survival for adenocarcinoma versus squamous cell carcinoma (HR 2.976 (95% CI 2.226 to 3.977), p<0.001) and for adenosquamous carcinoma versus squamous cell carcinoma (HR 2.295 (95% CI 1.579 to 3.338), p<0.001).ConclusionSquamous cell carcinoma, adenocarcinoma, and adenosquamous carcinoma carried distinctive patterns of clinicopathologic characteristics. Adenocarcinoma and adenosquamous carcinoma had worse survival outcomes than squamous cell carcinoma.

scholarly journals Prognostic Role of Squamous Cell Carcinoma Antigen in Cervical Cancer: A Meta-analysis

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
Zhenhua Liu ◽  
Hongtai Shi
Keyword(s):  
Cervical Cancer ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Poor Prognosis ◽  
Cancer Prognosis ◽  
High Expression ◽  
Cochrane Library ◽  
Squamous Cell Carcinoma Antigen ◽  
Free Survival

Objective. To systematically evaluate the significance of squamous cell carcinoma antigen (SCC-Ag) in the prognosis of cervical cancer. Methods. Literature from Pubmed, Embase, and Cochrane Library was retrieved to collect all English literature on the correlation between SCC-Ag and cervical cancer prognosis, and the quality of literature collected was assessed based on evaluation criteria. The heterogeneity, sensitivity, and specificity were detected using the StataSE12.0 software, and the correlation between SCC-Ag and cervical cancer prognosis as the effect variables was assessed using the hazard ratio (HR) and 95% confidence interval (CI). Moreover, the forest map and funnel plot were drawn. Results. A total of 17 articles meeting the inclusion criteria were selected. The high expression of SCC-Ag was significantly correlated with the poor prognosis of cervical cancer (HR=2.22, 95% CI=1.38−3.57, P=0.002). The disease-free survival (DFS) was higher in low SCC-Ag expression patients than in high SCC-Ag expression patients (HR=2.17, 95% CI=1.84−2.57, P<0.001). The progression-free survival (PFS) was inferior in patients with a high SCC-Ag expression (HR=2.70, 95% CI=1.11−6.53, P=0.028). Conclusion. SCC-Ag is an important prognostic factor for cervical cancer, and its high expression is significantly correlated with a poor prognosis of the disease.

Phase II trial of bleomycin, ifosfamide, and carboplatin in metastatic cervical cancer.

1994 ◽  
Vol 12 (1) ◽  
pp. 55-59 ◽  
Author(s):  
A M Murad ◽  
S A Triginelli ◽  
J C Ribalta
Keyword(s):  
Cervical Cancer ◽  
Overall Survival ◽  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
Median Overall Survival ◽  
Tumor Response ◽  
Survival Duration ◽  
Outpatient Basis ◽  
Free Survival

PURPOSE A bleomycin, carboplatin, and ifosfamide (BIC) chemotherapy protocol was designed to evaluate tumor response and palliation in patients with advanced cervical cancer. PATIENTS AND METHODS Forty patients with stage IV primary or recurrent squamous cell carcinoma of the cervix (19 previously irradiated and 21 nonirradiated) were assigned to treatment with six cycles of BIC: bleomycin, 30 mg bolus on day 1; carboplatin, 200 mg/m2 bolus on day 1; and ifosfamide, 2g/m2 for 3 consecutive days, infused over 2 hours. Mesna was administered as a bolus 15 minutes, and 4 and 8 hours after ifosfamide at 20% (intravenous [IV]), and 40% (orally, at home) of the ifosfamide dose, respectively. RESULTS Thirty-five patients (27 stage IVA and eight stage IVB) were considered eligible for response and toxicity evaluation. After a median of four cycles (maximum of six in responders), we observed objective responses in 21 patients (60%), with eight complete responses (CRs; 23%), including two histologically documented by laparotomy, and 13 (37%) partial responses (PRs) (95% confidence limits, 44% to 76%, 9% to 37%, and 21% to 53%, respectively). Median overall survival duration was 11 months (range, 3 to 24+). Median overall survival duration in the nonirradiated group was 17 months versus 4 months in the previously irradiated group (P = .005). The median progression-free survival duration of the responders was 12 months, and the median disease-free survival duration of the complete responders was 14 months. Toxicity was acceptable and included manageable alopecia, vomiting, and neutropenia. There was one toxic death due to febrile neutropenia and sepsis. CONCLUSION BIC can be administered on an outpatient basis and seems to be effective in inducing tumor response and palliation in patients with disseminated squamous cell carcinoma of cervix, with a possible survival benefit for previously nonirradiated patients, with an acceptable toxicity profile.

scholarly journals Matched-Pair Analysis of Survival in the Patients with Advanced Laryngeal and Hypopharyngeal Squamous Cell Carcinoma Treated with Induction Chemotherapy Plus Chemo-Radiation or Total Laryngectomy

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1735
Author(s):  
Patricia García-Cabo ◽  
Fernando López ◽  
Mario Sánchez-Canteli ◽  
Laura Fernández-Vañes ◽  
César Álvarez-Marcos ◽  
...  
Keyword(s):  
Squamous Cell Carcinoma ◽  
Cell Carcinoma ◽  
Induction Chemotherapy ◽  
Squamous Cell ◽  
Organ Preservation ◽  
Matched Pair ◽  
Primary Tumors ◽  
Free Survival ◽  
Tumor Node Metastasis Stage ◽  
Significant Difference

Background: We performed a comparative analysis between an organ-preservation protocol and surgery followed by radiotherapy in patients with locally advanced squamous cell carcinoma of the larynx and hypopharynx; Methods: 60 previously untreated patients who were treated with induction chemotherapy followed by chemoradiotherapy in responders were compared with a control group of 60 patients treated with up-front surgery. Both groups were statistically comparable, according to the subsite, TNM (tumor-node-metastasis) stage, age, and sex; Results: Mean age was 58 years and 92% were male. No significant statistical difference was observed for overall survival (OS) (HR 0.75; 95% CI 0.48–1,18; P = 0.22) and disease-specific survival (DSS) (HR 0.98; 95% CI 0.52–1.83, P = 0.96). Also, there was no significant difference for recurrence-free survival (HR 0.931; 95% CI 0.57–1.71; P = 0.81), metastases-free survival (HR 2.23; 95% CI 0.67–7.41; P = 0.19), and the appearance of second primary tumors (HR 1.22; 95% CI 0.51–2.88; P = 0.64); Conclusions: The results of the organ-preservation approach did not appear inferior to those of surgery plus (chemo)radiotherapy for patients with T3/T4a larynx and T2–T4a hypopharynx cancer with respect to OS and DSS, locoregional control and metastases-free survival.

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