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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  &lt; 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  &lt; 0.001), SCC pre  ( HR  = 0.563,  P  = 0.041), and SCC post  ( HR  = 0.253,  P  &lt; 0.001) were independent predictors of PFS. Tumor measurement parameters showed a positive correlation with SCC-Ag ( P  &lt; 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.

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