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Optimized Cutoff Value of Serum Squamous Cell Carcinoma Antigen Concentration Accurately Predicts Recurrence After Curative Resection of Squamous Cell Carcinoma of the Esophagus

  • Thoracic Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Squamous cell carcinoma antigen (SCC-Ag) and carcinoembryonic antigen (CEA) are widely used in clinical practice to predict the prognosis of patients with esophageal squamous cell carcinoma (ESCC). However, their predictive values for prognosis are controversial. This study determined optimal cutoff values of serum SCC-Ag and CEA concentrations for predicting postoperative recurrence of ESCC, which enabled selection of high-risk patients.

Methods

The study retrospectively analyzed 427 patients who underwent curative resection for ESCC. The optimal cutoff values of preoperative SCC-Ag and CEA concentrations for predicting postoperative recurrence were determined using combined analysis of hazard ratios and sensitivities for recurrence. Using the optimal cutoff value, the study evaluated survival, recurrence patterns, and temporal changes in marker concentrations.

Results

The preoperative SCC-Ag concentration of 1.1 ng/ml was the optimal cutoff value for predicting postoperative recurrence, whereas precise cutoff values could not be determined for preoperative CEA concentrations. High preoperative SCC-Ag concentrations (> 1.1 ng/ml), which were significantly associated with more aggressive tumor phenotypes and shorter disease-free survival, were identified as an independent prognostic factor in the multivariable analysis. High preoperative SCC-Ag concentrations were significantly associated with greater prevalence of lung/pleura and local recurrences. Normalization of serum SCC-Ag concentrations after neoadjuvant treatment or esophagectomy was not associated with a decreased risk of postoperative recurrence.

Conclusions

The optimal cutoff value of preoperative SCC-Ag concentrations that predicted recurrence of ESCC was 1.1 ng/ml, illuminating the utility of serum SCC-Ag concentrations as an easily measurable tool for selecting a perioperative management strategy.

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Acknowledgement

We thank Edanz Group (www.edanzediting.com/ac) for editing a draft of the manuscript for this article.

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Authors and Affiliations

  1. Department of Gastroenterological Surgery (Surgery II), Nagoya University Graduate School of Medicine, Nagoya, Japan

    Mitsuro Kanda MD, FACS, Masahiko Koike MD, Dai Shimizu MD, Chie Tanaka MD, Daisuke Kobayashi MD, Norifumi Hattori MD, Masamichi Hayashi MD, FACS, Suguru Yamada MD, FACS, Goro Nakayama MD & Yasuhiro Kodera MD, FACS

  2. Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan

    Kenji Omae MD

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  1. Mitsuro Kanda MD, FACS
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  2. Masahiko Koike MD
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Correspondence to Mitsuro Kanda MD, FACS.

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Fig. S1

Hazard ratios and sensitivities for postoperative recurrences of preoperative squamous cell carcinoma antigen (SCC-Ag) concentrations at the higher range. (TIFF 6662 kb)

Fig. S2

Hazard ratios and sensitivities for postoperative recurrences at 0.2-ng/ml increments of preoperative carcinoembryonic antigen (CEA) concentrations. (TIFF 6923 kb)

Fig. S3

Overall survival curves according to preoperative squamous cell carcinoma antigen (SCC-Ag) concentrations. (TIFF 6921 kb)

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Kanda, M., Koike, M., Shimizu, D. et al. Optimized Cutoff Value of Serum Squamous Cell Carcinoma Antigen Concentration Accurately Predicts Recurrence After Curative Resection of Squamous Cell Carcinoma of the Esophagus. Ann Surg Oncol 27, 1233–1240 (2020). https://doi.org/10.1245/s10434-019-07977-6

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  • DOI: https://doi.org/10.1245/s10434-019-07977-6

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