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

Abstract 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.