The importance of choosing the right strategy to treat small cell carcinoma of the cervix: a comparative analysis of treatments.
The importance of choosing the right strategy to treat small cell carcinoma of the cervix: a comparative analysis of treatments.
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DOI：
10.1186/s12885-021-08772-x
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发表时间：
2021-09-23
期刊：
影响因子：
3.8
通讯作者：
Naganawa S
中科院分区：
文献类型：
--
作者：
Kawamura M;Koide Y;Murai T;Ishihara S;Takase Y;Murao T;Okazaki D;Yamaguchi T;Uchiyama K;Itoh Y;Kodaira T;Shibamoto Y;Mizuno M;Kikkawa F;Naganawa S
子宫颈小细胞癌（SCCC）的标准治疗尚未建立。在这项研究中，我们的目的是估计SCCC的最佳治疗策略。这是一项多中心回顾性研究。回顾性分析了2003年至2016年期间治疗的经病理证实的SCCC患者的病历。使用Kaplan-Meier方法绘制总生存期（OS）。使用对数秩检验和考克斯回归分析来评估根据分期、治疗策略和化疗方案的生存差异。收集了78例患者的数据，排除无免疫组织病理学染色的患者后，对65例患者进行了评价。入选患者的中位年龄为47岁（范围：24-83岁）。国际妇产科联合会（FIGO）2018年I-IIA、IIB-IVA、IVB期患者人数分别为23例（35%）、34例（52%）和8例（12%）。在53例接受化疗的患者中，35例和18例分别接受SCCC和非SCCC方案作为其一线化疗方案。所有患者的5年OS为49%，而FIGO I-IIA、IIB-IVA、IVB期患者的5年OS分别为60%、50%和0%。接受SCCC和非SCCC方案治疗的患者的5年OS率分别为59%和13%（p < 0.01）。这种趋势在局部晚期阶段很明显。多因素分析显示，初次诊断时FIGO IVB是所有患者的重要预后因素。在53例接受化疗的患者中，单因素和多因素分析显示，SCCC方案与显著更好的5年OS相关。我们的研究结果表明，局部晚期SCCC患者的一线化疗方案，如EP或IP的应用可能在OS中发挥关键作用。这些研究结果需要在未来的全国范围内，前瞻性临床研究进行验证。在线版本包含补充材料，可通过10.1186/s12885-021-08772-x获得。
Standard treatments for small cell carcinoma of the cervix (SCCC) have not been established. In this study, we aimed to estimate the optimal treatment strategy for SCCC. This was a multicenter retrospective study. Medical records of patients with pathologically proven SCCC treated between 2003 and 2016 were retrospectively analyzed. Overall survival (OS) was plotted using the Kaplan-Meier method. Log-rank tests and Cox regression analysis were used to assess the differences in survival according to stage, treatment strategy, and chemotherapy regimen. Data of 78 patients were collected, and after excluding patients without immunohistopathological staining, 65 patients were evaluated. The median age of the included patients was 47 (range: 24–83) years. The numbers of patients with International Federation of Gynecology and Obstetrics (FIGO) 2018 stages I-IIA, IIB-IVA, IVB were 23 (35%), 34 (52%), and 8 (12%), respectively. Of 53 patients who had undergone chemotherapy, 35 and 18 received SCCC and non-SCCC regimens as their first-line chemotherapy regimen, respectively. The 5-year OS for all patients was 49%, while for patients with FIGO stages I-IIA, IIB-IVA, IVB, it was 60, 50, and 0%, respectively. The 5-year OS rates for patients who underwent treatment with SCCC versus non-SCCC regimens were 59 and 13% (p < 0.01), respectively. This trend was pronounced in locally advanced stages. Multivariate analysis showed that FIGO IVB at initial diagnosis was a significant prognostic factor in all patients. Among the 53 patients who received chemotherapy, the SCCC regimen was associated with significantly better 5-year OS in both the uni- and multivariate analyses. Our results suggest that the application of an SCCC regimen such as EP or IP as first-line chemotherapy for patients with locally advanced SCCC may play a key role in OS. These findings need to be validated in future nationwide, prospective clinical studies. The online version contains supplementary material available at 10.1186/s12885-021-08772-x.
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DOI：
10.1097/igc.0000000000001354
发表时间：
2018-11
期刊：
International journal of gynecological cancer : official journal of the International Gynecological Cancer Society
影响因子：
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作者：
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影响因子：
50.5
作者：
Lee, J. -M.;Lee, K. B.;Kang, S. -B.
通讯作者：
Kang, S. -B.
影响因子：
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作者：
McCusker, ME;Coté, TR;Tavassoli, FJ
通讯作者：
Tavassoli, FJ
影响因子：
4.7
作者：
Viswanathan, AN;Deavers, MT;Eifel, PJ
通讯作者：
Eifel, PJ
影响因子：
4.7
作者：
Zivanovic, O.;Leitao, M. M., Jr.;Aghajanian, C.
通讯作者：
Aghajanian, C.