Prognostic factors in FIGO stage IB-IIA small cell neuroendocrine carcinoma of the uterine cervix treated surgically: results of a multi-center retrospective Korean study
Prognostic factors in FIGO stage IB-IIA small cell neuroendocrine carcinoma of the uterine cervix treated surgically: results of a multi-center retrospective Korean study
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DOI：
10.1093/annonc/mdm465
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发表时间：
2008-02-01
影响因子：
50.5
通讯作者：
Kang, S. -B.
中科院分区：
文献类型：
--
作者：
Lee, J. -M.;Lee, K. B.;Kang, S. -B.
背景：探讨影响宫颈小细胞神经内分泌癌(SCNEC)手术治疗的临床和病理预后因素。患者与方法：回顾分析1997年1月至2003年12月收治的68例宫颈小细胞神经内分泌癌患者的临床资料。结果：68例患者中，FIGO 11311期43例，1132期15例，IIA期10例。7例仅接受根治性手术；11例接受新辅助化疗(NACT)，然后进行根治性手术；24例行根治性手术，然后进行辅助化疗；26例行根治性手术，然后进行辅助放疗或化疗。中位随访44个月(6~113个月)，2年和5年生存率分别为64.6%和46.6%。单因素和多因素分析显示，FIGO分期预示预后不良。接受NACT治疗的患者比未接受NACT治疗的患者预后更差。与单纯辅助化疗相比，辅助放化疗并不能提高患者的生存率。结论：FIGO分期可作为预后因素的替代指标。早期SCNEC患者首选的治疗方法是一期根治性手术后辅以化疗。
Background: To determine the clinical and pathologic prognostic factors in surgically treated patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB-IIA small cell neuroendocrine carcinoma of the uterine cervix (SCNEC).Patients and methods: We retrospectively reviewed a total of 68 patients with AGO stage IB-IIA SCNEC surgically treated from January 1997 to December 2003 in Korea.Results: Of the 68 patients, 43 had FIGO stage 11311 SCNEC, 15 had stage 1132, and 10 had stage IIA. Seven were treated with radical surgery alone; 11 with neoadjuvant chemotherapy (NACT) followed by radical surgery; 24 with radical surgery followed by adjuvant chemotherapy; and 26 with radical surgery followed by adjuvant radiation or chemoradiation. After a median follow-up of 44 months (range, 6-113 months), the 2-year and 5-year survival rates for all patients were 64.6% and 46.6%, respectively. Univariate and multivariate analysis showed that FIGO stage was predictive of poor prognosis. Patients who received NACT showed poorer prognosis than those who did not receive NACT. Adjuvant chemoradiation did not improve survival compared with adjuvant chemotherapy alone.Conclusions: FIGO stage may act as a surrogate for factors prognostic of survival. Primary radical surgery followed by adjuvant chemotherapy is the preferred treatment modality for patients with early stage SCNEC.