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Published in: Annals of Surgical Oncology 2/2021

01-02-2021 | Esophagus Resection | Translational Research and Biomarkers

Clinical Significance of Pretherapeutic Serum Squamous Cell Carcinoma Antigen Level in Patients with Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma

Authors: Akihiko Okamura, MD, PhD, Satoru Matsuda, MD, PhD, Shuhei Mayanagi, MD, PhD, Jun Kanamori, MD, PhD, Yu Imamura, MD, PhD, Tomoyuki Irino, MD, PhD, Hirofumi Kawakubo, MD, PhD, Shinji Mine, MD, PhD, Hiroya Takeuchi, MD, PhD, Yuko Kitagawa, MD, PhD, Masayuki Watanabe, MD, PhD

Published in: Annals of Surgical Oncology | Issue 2/2021

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Abstract

Background

Although squamous cell carcinoma antigen (SCC-Ag) is a tumor marker widely used to estimate the progression of esophageal SCC (ESCC), only a few studies have focused on the relationship between serum SCC-Ag levels and the therapeutic effect of neoadjuvant chemotherapy (NAC).

Objective

This study aimed to elucidate the clinical significance of pretherapeutic serum SCC-Ag levels in patients who underwent NAC followed by esophagectomy.

Methods

Data of 453 patients who underwent NAC followed by esophagectomy were collected from the esophageal cancer database of two high-volume Japanese centers. Serum SCC-Ag levels were measured prior to NAC, and the pathological therapeutic effect of NAC and patient survival were evaluated. Patients were classified according to the tertiles of the serum SCC-Ag value (low, middle, and high groups), and the outcomes among the groups were compared.

Results

The levels of serum SCC-Ag were significantly associated with tumor stage (p < 0.01). With regard to the pathological therapeutic effect, the levels of serum SCC-Ag were negatively correlated with the therapeutic effect (p = 0.02). Moreover, increased levels of serum SCC-Ag negatively influenced relapse-free survival (p < 0.01). Multivariate analyses revealed the ‘high’ group as the independent factor for both the unfavorable therapeutic effect (p = 0.01) and the increased risk of disease recurrence (p < 0.01) when compared with the ‘low’ group.

Conclusion

Elevated levels of pretherapeutic serum SCC-Ag are significantly associated with advanced tumor stage, poor response to NAC, and increased risk of disease recurrence.
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Literature
1.
go back to reference Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med. 2003;349:2241–52.CrossRef Enzinger PC, Mayer RJ. Esophageal cancer. N Engl J Med. 2003;349:2241–52.CrossRef
2.
go back to reference Lagergren J, Smyth E, Cunningham D, Lagergren P. Oesophageal cancer. Lancet. 2017;390:2383–96.CrossRef Lagergren J, Smyth E, Cunningham D, Lagergren P. Oesophageal cancer. Lancet. 2017;390:2383–96.CrossRef
3.
go back to reference Ando N, Kato H, Igaki H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5–fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19:68–74.CrossRef Ando N, Kato H, Igaki H, et al. A randomized trial comparing postoperative adjuvant chemotherapy with cisplatin and 5–fluorouracil versus preoperative chemotherapy for localized advanced squamous cell carcinoma of the thoracic esophagus (JCOG9907). Ann Surg Oncol. 2012;19:68–74.CrossRef
4.
go back to reference Kitagawa Y, Uno T, Oyama T, et al. Esophageal cancer practice guidelines 2017 edited by the Japan Esophageal Society: part 1. Esophagus. 2019;16:1–24.CrossRef Kitagawa Y, Uno T, Oyama T, et al. Esophageal cancer practice guidelines 2017 edited by the Japan Esophageal Society: part 1. Esophagus. 2019;16:1–24.CrossRef
5.
go back to reference Kitagawa Y, Uno T, Oyama T, et al. Esophageal cancer practice guidelines 2017 edited by the Japan esophageal society: part 2. Esophagus. 2019;16:25–43.CrossRef Kitagawa Y, Uno T, Oyama T, et al. Esophageal cancer practice guidelines 2017 edited by the Japan esophageal society: part 2. Esophagus. 2019;16:25–43.CrossRef
6.
go back to reference Torre GC. SCC antigen in malignant and nonmalignant squamous lesions. Tumour Biol. 1998;19:517–26.CrossRef Torre GC. SCC antigen in malignant and nonmalignant squamous lesions. Tumour Biol. 1998;19:517–26.CrossRef
7.
go back to reference Shimada H, Nabeya Y, Okazumi S, et al. Prediction of survival with squamous cell carcinoma antigen in patients with resectable esophageal squamous cell carcinoma. Surgery. 2003;133:486–94.CrossRef Shimada H, Nabeya Y, Okazumi S, et al. Prediction of survival with squamous cell carcinoma antigen in patients with resectable esophageal squamous cell carcinoma. Surgery. 2003;133:486–94.CrossRef
8.
go back to reference Kosugi S, Nishimaki T, Kanda T, Nakagawa S, Ohashi M, Hatakeyama K. Clinical significance of serum carcinoembryonic antigen, carbohydrate antigen 19–9, and squamous cell carcinoma antigen levels in esophageal cancer patients. World J Surg. 2004;28:680–5.CrossRef Kosugi S, Nishimaki T, Kanda T, Nakagawa S, Ohashi M, Hatakeyama K. Clinical significance of serum carcinoembryonic antigen, carbohydrate antigen 19–9, and squamous cell carcinoma antigen levels in esophageal cancer patients. World J Surg. 2004;28:680–5.CrossRef
9.
go back to reference 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. 2020;27:1233–1240.CrossRef 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. 2020;27:1233–1240.CrossRef
10.
go back to reference Brierley JD, Gospodarowicz MK, Wittekind C (eds). TNM classification of malignant tumors. International Union Against Cancer. 8th ed. Oxford: Wiley; 2017. Brierley JD, Gospodarowicz MK, Wittekind C (eds). TNM classification of malignant tumors. International Union Against Cancer. 8th ed. Oxford: Wiley; 2017.
11.
go back to reference Japan Esophageal Society. Japanese Classification of Esophageal Cancer, 11th Edition: part I. Esophagus. 2017;14:1–36.CrossRef Japan Esophageal Society. Japanese Classification of Esophageal Cancer, 11th Edition: part I. Esophagus. 2017;14:1–36.CrossRef
12.
go back to reference Japan Esophageal Society. Japanese Classification of Esophageal Cancer, 11th Edition: part II and III. Esophagus. 2017;14:37–65.CrossRef Japan Esophageal Society. Japanese Classification of Esophageal Cancer, 11th Edition: part II and III. Esophagus. 2017;14:37–65.CrossRef
13.
go back to reference Yokota T, Kato K, Hamamoto Y, et al. Phase II study of chemoselection with docetaxel plus cisplatin and 5–fluorouracil induction chemotherapy and subsequent conversion surgery for locally advanced unresectable oesophageal cancer. Br J Cancer. 2016;115:1328–34.CrossRef Yokota T, Kato K, Hamamoto Y, et al. Phase II study of chemoselection with docetaxel plus cisplatin and 5–fluorouracil induction chemotherapy and subsequent conversion surgery for locally advanced unresectable oesophageal cancer. Br J Cancer. 2016;115:1328–34.CrossRef
14.
go back to reference Yokota T, Kato K, Hamamoto Y, et al. A 3–year overall survival update from a phase 2 study of chemoselection with DCF and subsequent conversion surgery for locally advanced unresectable esophageal cancer. Ann Surg Oncol. 2020;27:460–7.CrossRef Yokota T, Kato K, Hamamoto Y, et al. A 3–year overall survival update from a phase 2 study of chemoselection with DCF and subsequent conversion surgery for locally advanced unresectable esophageal cancer. Ann Surg Oncol. 2020;27:460–7.CrossRef
15.
go back to reference Kato H, Torigoe T. Radioimmunoassay for tumor antigen of human cervical squamous cell carcinoma. Cancer. 1977;40:1621–8.CrossRef Kato H, Torigoe T. Radioimmunoassay for tumor antigen of human cervical squamous cell carcinoma. Cancer. 1977;40:1621–8.CrossRef
16.
go back to reference Suminami Y, Nagashima S, Vujanovic NL, Hirabayashi K, Kato H, Whiteside TL. Inhibition of apoptosis in human tumour cells by the tumour-associated serpin, SCC antigen-1. Br J Cancer. 2000;82:981–9.CrossRef Suminami Y, Nagashima S, Vujanovic NL, Hirabayashi K, Kato H, Whiteside TL. Inhibition of apoptosis in human tumour cells by the tumour-associated serpin, SCC antigen-1. Br J Cancer. 2000;82:981–9.CrossRef
17.
go back to reference Murakami A, Suminami Y, Hirakawa H, Nawata S, Numa F, Kato H. Squamous cell carcinoma antigen suppresses radiation-induced cell death. Br J Cancer. 2001;84:851–8.CrossRef Murakami A, Suminami Y, Hirakawa H, Nawata S, Numa F, Kato H. Squamous cell carcinoma antigen suppresses radiation-induced cell death. Br J Cancer. 2001;84:851–8.CrossRef
18.
go back to reference Markovina S, Wang S, Henke LE, et al. Serum squamous cell carcinoma antigen as an early indicator of response during therapy of cervical cancer. Br J Cancer. 2018;118:72–8.CrossRef Markovina S, Wang S, Henke LE, et al. Serum squamous cell carcinoma antigen as an early indicator of response during therapy of cervical cancer. Br J Cancer. 2018;118:72–8.CrossRef
19.
go back to reference Luke CJ, Pak SC, Askew YS, et al. An intracellular serpin regulates necrosis by inhibiting the induction and sequelae of lysosomal injury. Cell. 2007;130:1108–19.CrossRef Luke CJ, Pak SC, Askew YS, et al. An intracellular serpin regulates necrosis by inhibiting the induction and sequelae of lysosomal injury. Cell. 2007;130:1108–19.CrossRef
20.
go back to reference Yi Y, Li B, Wang Z, Sun H, Gong H, Zhang Z. CYFRA21–1 and CEA are useful markers for predicting the sensitivity to chemoradiotherapy of esophageal squamous cell carcinoma. Biomarkers. 2009;14:480–5.CrossRef Yi Y, Li B, Wang Z, Sun H, Gong H, Zhang Z. CYFRA21–1 and CEA are useful markers for predicting the sensitivity to chemoradiotherapy of esophageal squamous cell carcinoma. Biomarkers. 2009;14:480–5.CrossRef
21.
go back to reference Yi Y, Li B, Sun H, et al. Predictors of sensitivity to chemoradiotherapy of esophageal squamous cell carcinoma. Tumour Biol. 2010;31:333–40.CrossRef Yi Y, Li B, Sun H, et al. Predictors of sensitivity to chemoradiotherapy of esophageal squamous cell carcinoma. Tumour Biol. 2010;31:333–40.CrossRef
22.
go back to reference Yang Y, Huang X, Zhou L, et al. Clinical use of tumor biomarkers in prediction for prognosis and chemotherapeutic effect in esophageal squamous cell carcinoma. BMC Cancer. 2019;19:526.CrossRef Yang Y, Huang X, Zhou L, et al. Clinical use of tumor biomarkers in prediction for prognosis and chemotherapeutic effect in esophageal squamous cell carcinoma. BMC Cancer. 2019;19:526.CrossRef
23.
go back to reference Watanabe M, Baba Y, Yoshida N, et al. Outcomes of preoperative chemotherapy with docetaxel, cisplatin, and 5–fluorouracil followed by esophagectomy in patients with resectable node-positive esophageal cancer. Ann Surg Oncol. 2014;21:2838–44.CrossRef Watanabe M, Baba Y, Yoshida N, et al. Outcomes of preoperative chemotherapy with docetaxel, cisplatin, and 5–fluorouracil followed by esophagectomy in patients with resectable node-positive esophageal cancer. Ann Surg Oncol. 2014;21:2838–44.CrossRef
24.
go back to reference Takeuchi M, Kawakubo H, Mayanagi S, et al. The benefits of docetaxel plus cisplatin and 5–fluorouracil induction therapy in conversion to curative treatment for locally advanced esophageal squamous cell carcinoma. World J Surg. 2019;43:2006–15.CrossRef Takeuchi M, Kawakubo H, Mayanagi S, et al. The benefits of docetaxel plus cisplatin and 5–fluorouracil induction therapy in conversion to curative treatment for locally advanced esophageal squamous cell carcinoma. World J Surg. 2019;43:2006–15.CrossRef
25.
go back to reference Al-Batran SE, Homann N, Pauligk C, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet. 2019;393:1948–57.CrossRef Al-Batran SE, Homann N, Pauligk C, et al. Perioperative chemotherapy with fluorouracil plus leucovorin, oxaliplatin, and docetaxel versus fluorouracil or capecitabine plus cisplatin and epirubicin for locally advanced, resectable gastric or gastro-oesophageal junction adenocarcinoma (FLOT4): a randomised, phase 2/3 trial. Lancet. 2019;393:1948–57.CrossRef
26.
go back to reference Kato K, Cho BC, Takahashi M, et al. Nivolumab versus chemotherapy in patients with advanced oesophageal squamous cell carcinoma refractory or intolerant to previous chemotherapy (ATTRACTION-3): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2019;20:1506–17.CrossRef Kato K, Cho BC, Takahashi M, et al. Nivolumab versus chemotherapy in patients with advanced oesophageal squamous cell carcinoma refractory or intolerant to previous chemotherapy (ATTRACTION-3): a multicentre, randomised, open-label, phase 3 trial. Lancet Oncol. 2019;20:1506–17.CrossRef
Metadata
Title
Clinical Significance of Pretherapeutic Serum Squamous Cell Carcinoma Antigen Level in Patients with Neoadjuvant Chemotherapy for Esophageal Squamous Cell Carcinoma
Authors
Akihiko Okamura, MD, PhD
Satoru Matsuda, MD, PhD
Shuhei Mayanagi, MD, PhD
Jun Kanamori, MD, PhD
Yu Imamura, MD, PhD
Tomoyuki Irino, MD, PhD
Hirofumi Kawakubo, MD, PhD
Shinji Mine, MD, PhD
Hiroya Takeuchi, MD, PhD
Yuko Kitagawa, MD, PhD
Masayuki Watanabe, MD, PhD
Publication date
01-02-2021
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 2/2021
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-020-08716-y

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