title: Utility of serum squamous cell carcinoma antigen levels at the time of recurrent cervical cancer diagnosis in determining the optimal treatment choice.
abstract: OBJECTIVE
  To investigate the utility of serum squamous cell carcinoma antigen (SCC-Ag) levels upon the diagnosis of recurrent cervical cancer for decision making in patient management.
  
  
  METHODS
  Clinical records from 167 cervical cancer patients who developed recurrence between April 1996 and September 2010 were reviewed. A Cox proportional hazards regression model was used to investigate the prognostic significance of serum SCC-Ag levels at the time of recurrence. The effects of various salvage treatments on survival outcomes of recurrent cervical cancer were examined with respect to serum SCC-Ag levels.
  
  
  RESULTS
  Serum SCC-Ag levels were elevated (>2.0 ng/mL) in 125 patients (75%) when recurrence was diagnosed. These patients exhibited significantly shorter postrecurrence survival than those with normal SCC-Ag levels (log-rank; p=0.033). Multivariate analyses revealed that an elevated serum SCC-Ag level was an independent prognostic factor for poor postrecurrence survival. In patients with SCC-Ag levels <14.0 ng/mL, radiotherapy or surgery resulted in improved survival compared with chemotherapy or supportive care. In contrast, in patients with SCC-Ag levels of ≥14.0 ng/mL, salvage treatment with radiotherapy had only a minimal impact on postrecurrence survival.
  
  
  CONCLUSIONS
  The serum SCC-Ag level measured when cervical cancer recurrence is diagnosed can be useful for deciding upon the appropriate salvage treatment.
authors.affiliation: Department of Obstetrics and Gynecology, Osaka University Graduate School of Medicine, Osaka, Japan.
authors.forename: Kotaro
authors.initials: K
authors.lastname: Shimura
authors.forename: Seiji
authors.initials: S
authors.lastname: Mabuchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yokoi
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Sasano
authors.forename: Kenjirou
authors.initials: K
authors.lastname: Sawada
authors.forename: Toshimitsu
authors.initials: T
authors.lastname: Hamasaki
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kimura
keywords: Decision-making; Recurrent cervical cancer; Squamous cell carcinoma antigen; Survival