Prognostic Impact of Carcinoembryonic Angtigen (CEA) in Locally Advanced Cervical Cancer Treated with Concurrent Chemoradiotherapy

Abstract

Objective: To identify prognostic factors in patients with locally advanced cervical cancer treated with concurrent chemoradiotherapy (CCRT). Methods and Materials: We analyzed 76 patients with FIGO stage IB2 - IVb cervical cancer treated with CCRT between 2001 and 2006 at the Nagoya University Hospital. Patients with an advanced cervical cancer treated with CCRT. Overall survival (OS) and Progression-free survival (PFS) rates were estimated using the Kaplan-Meier method. The log-rank test was used to test differences in survival. Fisher's exact test was employed for univariate analysis. The Cox proportional hazard model was used for multivariate analysis. Results: The median age was 52, and the median follow-up period was 36 months. The 5 - year OS and PFS rates of all patients were 88.2% and 72.4%, respectively. Twenty-one of the 76 patients were diagnosed with recurrence. A higher serum CEA before CCRT was an independent predictive factor for a poor prognosis on multivariate analysis. Conclusions: A high level of serum CEA was a predictive factor for a poor prognosis. New strategies should be considered to control disease in this group of patients.

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K. Shibata, H. Kajiyama, M. Mizuno, E. Yamamoto and F. Kikkawa, "Prognostic Impact of Carcinoembryonic Angtigen (CEA) in Locally Advanced Cervical Cancer Treated with Concurrent Chemoradiotherapy," Surgical Science, Vol. 3 No. 10, 2012, pp. 463-468. doi: 10.4236/ss.2012.310092.

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1] M. Parkin, F. Bray, J. Ferlay and P. Pisani, “Global Cancer Statistics,” CA: A Cancer Journal for Clinicians, Vol. 55, No. 2, 2005, pp. 74-108. doi:10.3322/canjclin.55.2.74
[2] L.-C. Horn, U. Fischer, G. Raptis, K. Bilek and B. Hentschel, “Tumor Size Is of Prognostic Value in Surgically Treated FIGO Stage II Cervical Cancer,” Gynecologic Oncology, Vol. 107, No. 2, 2007, pp. 310-315. doi:10.1016/j.ygyno.2007.06.026
[3] C. A. Perez, P. W. Grigsby, K. S. Chao, D. G. Mutch and M. A. Lockett, “Tumor Size, Irradiation Dose, and Long-Term Outcome of Carcinoma of Uterine Cervix,” International Journal of Radiation Oncology, Biology, Physics, Vol. 41, No. 2, 1998, pp. 307-317. doi:10.1016/S0360-3016(98)00067-4
[4] M. Morris, P. J. Eifel, J. Lu, et al., “Pelvic Radiation with Concurrent Chemotherapy Compared with Pelvic and Para-Aortic Radiation for High-Risk Cervical Cancer,” The New England Journal of Medicine, Vol. 340, No. 15, 1999, pp. 1137-1143. doi:10.1056/NEJM199904153401501
[5] H. M. Keys, B. N. Bundy, F. B. Stehman, et al., “Cisplatin, Radiation, and Adjuvant Hysterectomy Compared with Radiation and Adjuvant Hysterectomy for Bulky Stage IB Cervical Carcinoma,” The New England Journal of Medicine, Vol. 340, No. 15, 1999, pp. 1154-1161. doi:10.1056/NEJM199904153401503
[6] P. G. Rose, B. N. Bundy, E. B. Watkins, et al., “Concurrent Cisplatin-Based Radiotherapy and Chemotherapy for Locally Advanced Cervical Cancer,” The New England Journal of Medicine, Vol. 340, No. 15, 1999, pp. 1144-1153. doi:10.1056/NEJM199904153401502
[7] W. A. Peters III, P. Y. Liu, R. Barrett, et al., “Concurrent Chemotherapy and Pelvic Radiation Therapy Compared with Pelvic Radiation Therapy Alone as Adjuvant Therapy after Radical Surgery in High-Risk Early-Stage Cancer of the Cervix,” Journal of Clinical Oncology, Vol. 18, No. 8, 2000, pp. 1606-1613. doi:10.1097/00006254-200008000-00017
[8] K. Shibata, F. Kikkawa, Y. Suzuki, et al., “Usefulness of Preoperative Chemoradiation in Locally Advanced Cervical Carcinoma,” Gynecologic and Obstetric Investigation, Vol. 57, No. 2, 2004, pp. 93-99. doi:10.1159/000075385
[9] C. W. Whitney, W. Sause, B. N. Bundy, et al., “A Randomized Comparison of Fluorouracil Plus Cisplatin versus Hydroxyurea as an Adjunct to Radiation Therapy in Stage IIB-IVA Carcinoma of the Cervix with Negative Para-Aortic Lymph Nodes: A Gynecologic Oncology Group and Southwest Oncology Group Study,” Journal of Clinical Oncology, Vol. 17, No. 5, 1999, pp. 1339-1348.
[10] R. Pearcey, M. Brundage, P. Drouin, et al., “Phase III Trial Comparing Radical Radiotherapy with and without Cisplatin Chemotherapy in Patients with Advanced Squamous Cell Cancer of the Cervix,” Journal of Clinical Oncology, Vol. 20, No. 4, 2002, pp. 966-972. doi:10.1200/JCO.20.4.966
[11] R. S. Lavey, P. Y. Liu, B. E. Greer, et al., “Recombinant Human Erythropoietin as an Adjunct to Radiation Therapy and Cisplatin for Stage IIB-IVA Carcinoma of the Cervix: A Southwest Oncology Group Study,” Gynecologic Oncology, Vol. 95, No. 1, 2004, pp. 145-151. doi:10.1016/j.ygyno.2004.07.009
[12] P. W. Grigsby, M. L. Vest and C. A. Perez, “Recurrent Carcinoma of the Cervix Exclusively in the Paraaortic Nodes Following Radiation Therapy,” International Journal of Radiation Oncology, Biology, Physics, Vol. 28, No. 2, 1994, pp. 451-455. doi:10.1016/0360-3016(94)90070-1
[13] H.-H. Chou, C.-C. Wang, C.-H. Lai, et al., “Isolated Paraaortic Lymph Node Recurrence after Definitive Irradiation for Cervical Carcinoma,” International Journal of Radiation Oncology, Biology, Physics, Vol. 51, No. 2, 2001, pp. 442-448. doi:10.1016/S0360-3016(01)01628-5
[14] S. M. Yoon, K. H. Shin, J.-Y. Kim, et al., “The Clinical Values of Squamous Cell Carcinoma Antigen and Carcinoembryonic Antigen in Patients with Cervical Cancer Treated with Concurrent Chemoradiotherapy,” International Journal of Gynecological Cancer, Vol. 17, No. 4, 2007, pp. 872-878. doi:10.1111/j.1525-1438.2007.00878.x
[15] A. Gadducci, R. Tana, A. Fanucchi and A. R. Genazzani, “Biochemical Prognostic Factors and Risk of Relapses in Patients with Cervical Cancer,” Gynecologic Oncology, Vol. 107, No. 1, 2007, pp. S23-S26. doi:10.1016/j.ygyno.2007.07.033
[16] M. Hirakawa, Y. Nagai, M. Inamine, et al., “Predictive Factor of Distant Recurrence in Locally Advanced Squamous Cell Carcinoma of the Cervix Treated with Concurrent Chemoradiotherapy,” Gynecologic Oncology, Vol. 108, No. 1, 2008, pp. 126-129. doi:10.1016/j.ygyno.2007.08.091

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