Primary treatment and prognostic factors of small cell neuroendocrine carcinoma of the uterine cervix: A Taiwanese Gynecologic Oncology Group study
Primary treatment and prognostic factors of small cell neuroendocrine carcinoma of the uterine cervix: A Taiwanese Gynecologic Oncology Group study
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DOI：
10.1016/j.ejca.2011.12.014
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发表时间：
2012-07-01
影响因子：
8.4
通讯作者：
Lai, Chyong-Huey
中科院分区：
文献类型：
--
作者：
Wang, Kung-Liahng;Chang, Ting-Chang;Lai, Chyong-Huey
背景资料：我们的目的是探讨小细胞神经内分泌宫颈癌（SCNECC）的治疗和临床病理变量与预后的关系。患者和方法：回顾性分析了1987年至2009年在台湾妇科肿瘤组（TGOG）成员医院治疗的国际妇产科联盟（FIGO）I-IV期SCNECC患者的临床数据。在179例合格患者中，104例为FIGO I期，19例为IIA期，23例为IIB期，9例为III期，24例为IV期。中位无失败生存期（FFS）为16.0个月，中位癌症特异性生存期（CSS）为24.8个月。在多因素分析中，选择FIGO分期和淋巴结转移作为I-IV期的独立变量。在IIB-IVB期，与其他治疗（n = 40）相比，含依托泊苷和铂至少5个周期（EP 5+）（n = 16）的主要治疗与显著更好的5年FFS（42. 9% vs 11. 8%，p = 0. 041）和CSS（45. 6% vs 17. 1%，p = 0. 035）相关。此外，同步放化疗联合EP 5+（CCRT-EP 5+）与更好的5年FFS（62.5%vs 13.1%，p = 0.025）和CSS（75.0%vs 16.9%，p = 0.016）相关。结论：FIGO分期和淋巴结转移是SCNECC的重要预后因素。在IIB-IVB阶段，CCRT-EP 5+可能是治疗的选择，这也可能适用于早期阶段。尽管回顾性研究的局限性，跨越很长的时间段和异质性管理，结果提供了一个重要的基础，设计未来的前瞻性研究。(C)2011爱思唯尔有限公司保留所有权利。
Background: Our aims were to investigate the treatment and clinicopathological variables in relation to prognosis in small cell neuroendocrine cervical carcinoma (SCNECC).Patients and methods: Clinical data of SCNECC patients with International Federation of Gynaecology and Obstetrics (FIGO) stages I-IV treated between 1987 and 2009 at member hospitals of the Taiwanese Gynecologic Oncology Group (TGOG) were retrospectively reviewed.Results: Of the 179 eligible patients, 104 were of FIGO stage I, 19 stage IIA, 23 stage IIB, 9 stage III, and 24 stage IV. The median failure-free survival (FFS) was 16.0 months, and the median cancer-specific survival (CSS) was 24.8 months. In multivariate analysis, FIGO stage and lymph node metastasis were selected as independent variables in stages I-IV. In stages IIB-IVB, primary treatment containing etoposide and platinum for at least 5 cycles (EP5+) (n = 16) was associated with significantly better 5-year FFS (42.9% versus 11.8%, p = 0.041) and CSS (45.6% versus 17.1%, p = 0.035) compared to other treatments (n = 40). Furthermore, concurrent chemoradiation with EP5+ (CCRT-EP5+) was associated with even better 5-year FFS (62.5% versus 13.1%, p = 0.025) and CSS (75.0% versus 16.9%, p = 0.016).Conclusions: FIGO stage and lymph node metastasis are significant prognostic factors in SCNECC. In stages IIB-IVB, CCRT-EP5+ might be the treatment of choice, which could be also true for earlier stages. Despite limitations of a retrospective study spanning a long time period and heterogeneous managements, the results provide an important basis for designing future prospective studies. (C) 2011 Elsevier Ltd. All rights reserved.