Pretreatment carcinoembryonic antigen level is a risk factor for para-aortic lymph node recurrence in addition to squamous cell carcinoma antigen following definitive concurrent chemoradiotherapy for squamous cell carcinoma of the uterine cervix

Radiation Oncology

Chang-Yu Wang⁴  Hsuan-Chih Hsu¹  Hui-Chun Chen⁴  Hung-Chun Fu⁵  Yu-Che Ou⁵  Ching-Chou Tsai⁵  Chin-Wen Tseng⁶  Li-Min Sun³  Chong-Jong Wang⁴  Hao Lin⁵  Chan-Chao Chanchien⁵  Yu-Jie Huang⁴  Eng-Yen Huang² 

[1] School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan;School of Traditional Chinese Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan;Department of Radiation Oncology, Zuoying Armed Forces General Hospital, Kaohsiung, Taiwan;Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;Department of Gynecologic Oncology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan;Department of Gynecologic Oncology, Chia-Yi Chang Gung Memorial Hospital, Chia-Yi, Taiwan

关键词: radiotherapy;    SCC-Ag;    uterine cervix;    squamous cell carcinoma;    para-aortic lymph node;    carcinoembryonic antigen;   

Others  :  1160903
DOI  :  10.1186/1748-717X-7-13

 received in 2011-07-23, accepted in 2012-01-30,  发布年份 2012

【 摘 要 】

Background

To identify pretreatment carcinoembryonic antigen (CEA) levels as a risk factor for para-aortic lymph node (PALN) recurrence following concurrent chemoradiotherapy (CCRT) for cervical cancer.

Methods

From March 1995 to January 2008, 188 patients with squamous cell carcinoma (SCC) of the uterine cervix were analyzed retrospectively. No patient received PALN irradiation as the initial treatment. CEA and squamous cell carcinoma antigen (SCC-Ag) were measured before and after radiotherapy. PALN recurrence was detected by computer tomography (CT) scans. We analyzed the actuarial rates of PALN recurrence by using Kaplan-Meier curves. Multivariate analyses were carried out with Cox regression models. We stratified the risk groups based on the hazard ratios (HR).

Results

Both pretreatment CEA levels ≥ 10 ng/mL and SCC-Ag levels < 10 ng/mL (p < 0.001, HR = 8.838), SCC-Ag levels ≥ 40 ng/mL (p < 0.001, HR = 12.551), and SCC-Ag levels of 10-40 ng/mL (p < 0.001, HR = 4.2464) were significant factors for PALN recurrence. The corresponding 5-year PALN recurrence rates were 51.5%, 84.8%, and 27.5%, respectively. The 5-year PALN recurrence rate for patients with both low (< 10 ng/mL) SCC and CEA was only 9.6%. CEA levels ≥ 10 ng/mL or SCC-Ag levels ≥ 10 ng/mL at PALN recurrence were associated with overall survival after an isolated PALN recurrence. Pretreatment CEA levels ≥ 10 ng/mL were also associated with survival after an isolated PALN recurrence.

Conclusions

Pretreatment CEA ≥ 10 ng/mL is an additional risk factor of PALN relapse following definitive CCRT for SCC of the uterine cervix in patients with pretreatment SCC-Ag levels < 10 ng/mL. More comprehensive examinations before CCRT and intensive follow-up schedules are suggested for early detection and salvage in patients with SCC-Ag or CEA levels ≥ 10 ng/mL.

【 授权许可】

   
2012 Huang et al; licensee BioMed Central Ltd.

【 图 表 】

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