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Prognostic significance of serum concentration of squamous cell carcinoma antigen in anal epidermoid carcinoma



Prognostic significance of serum concentration of squamous cell carcinoma antigen in anal epidermoid carcinoma



International Journal of Colorectal Disease 8(2): 98-102



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 (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 nor-mat 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). In multivariate Cox regression analyses SCCAg concentration was found to be the most significant determinant of risk for overall and tumour specific death as well as for residual or recurrent tumour. SCCAg serum concentration may be a useful prognostic indicator which could be used in selecting high risk patients for a more aggressive primary treatment.

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Accession: 009254686

Download citation: RISBibTeXText

PMID: 7691975

DOI: 10.1007/bf00299336


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