Prognostic value of tumor measurement parameters and SCC-Ag changes in patients with locally-advanced cervical cancer

OBJECTIVE: To investigate the prognostic relevance of specific measurement parameters such as tumor diameter, tumor volume, tumor volume reduction rate (TVRR), and changes in the squamous cell carcinoma antigen (SCC-Ag) level in patients with locally-advanced cervical cancer (LACC) undergoing concurrent radiotherapy and chemotherapy. METHODS: This was a retrospective study of 203 patients with stage IIA–IVA cervical squamous cell carcinoma who were newly diagnosed at our hospital between January 2011 and March 2015. Clinical data and pre-and post-treatment imaging information were collected and each parameter was calculated using 3DSlicer software. The pre/post-treatment tumor diameter (TD(pre/post)), tumor volume (TV(pre/post)), SCC-Ag (SCC(pre/post)), and TVRR, SCC-Ag reduction rate (SCCRR) were analyzed and their prognostic relevance evaluated. RESULTS: The median follow-up was 69 months. The 5-year overall survival (OS) and disease progression-free survival (PFS) rates were 69.5% and 64.5%, respectively. On univariate analysis, TD(pre/post), TV(pre/post), TVRR, SCC(pre/post) and SCCRR showed significant association with OS and PFS (P < 0.05). On multivariate analysis, TD(pre) [Hazard ratio (HR) = 0.373, P = 0.028], TD(post) (HR = 0.376, P = 0.003) and SCC(post) (HR = 0.374, P = 0.001) were independent predictors of OS. TVRR (HR = 2.998, P < 0.001), SCC(pre) (HR = 0.563, P = 0.041), and SCC(post) (HR = 0.253, P < 0.001) were independent predictors of PFS. Tumor measurement parameters showed a positive correlation with SCC-Ag (P < 0.05). CONCLUSION: TD(pre/post), TV(pre/post), TVRR, SCC(pre/post), and SCCRR were prognostic factors in LACC. TD(pre/post) and SCC(post) showed the most significant prognostic value. TVRR and SCC(pre/post) were closely related to disease progression. Further studies should investigate the correlation between measurement parameters of tumor and SCC-Ag.