Prognostic significance of serum concentration of squamous cell carcinoma antigen in anal epidermoid carcinoma.
The prognostic significance of pre-treatment serum concentration of squamous cell carcinoma antigen (SCCAg) was investigated in a population of 60 patients with anal epidermoid cancer. Serum concentration was determined during the period 1985-90. The patients were followed until December 1991. An antigen level above 2.0 ng/ml was classified as elevated. Thirty-eight patients had T1-2 tumours, while 22 had T3-4 tumours. Sixteen of the 20 patients (80%) with an elevated SCCAg concentration relapsed or had residual tumour after conclusion of primary therapy, compared to 8 of 40 (20%) with a normal concentration (P = 0.00001). Six patients of 40 (15%) with a normal SCCAg had died at the end of follow-up compared to 10 of 20 (50%) with an elevated value (P = 0.006). For patients with T1-2 tumours 2 of 29 (7%) with a normal SCCAg had died with or from their cancer compared to 3 of 9 (33%) with an elevated value (P = 0.14); for T3-4 tumours these figures were 3 of 11 (P = 0.14); for T3-4 tumours these figures were 3 of 11 (27%) and 7 of 11 (64%) respectively (P = 0.009). Actuarial survival analyses for patients with normal vs elevated SCCAg concentration showed that the projected five year overall survival was 81% for those with a normal level and 43% for those with an elevated level (P = 0.004). For tumour specific survival the figures were 83% vs 45% (P = 0.004).(ABSTRACT TRUNCATED AT 250 WORDS)
Goldman
S
S
Department of Surgery, Ersta Hospital, Stockholm, Sweden.
Svensson
C
C
Brönnergård
M
M
Glimelius
B
B
Wallin
G
G
D000206:Actuarial Analysis; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000951:Antigens, Neoplasm / Q000097:blood*; D001005:Anus Neoplasms / Q000097:blood / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D014408:Biomarkers, Tumor / Q000097:blood*; D001761:Bleomycin / Q000008:administration & dosage; D002294:Carcinoma, Squamous Cell / Q000097:blood / Q000401:mortality* / Q000473:pathology / Q000532:radiotherapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D011446:Prospective Studies; D011879:Radiotherapy Dosage; D012044:Regression Analysis; D015843:Serpins; D013548:Sweden / Q000453:epidemiology
D000951:Antigens, Neoplasm; D014408:Biomarkers, Tumor; D015843:Serpins; C051072:squamous cell carcinoma-related antigen; D001761:Bleomycin