Clinicopathologic features, treatment, prognosis and prognostic factors of neuroendocrine carcinoma of the endometrium: a retrospective analysis of 42 cases from the Kansai Clinical Oncology Group/Intergroup study in Japan
Clinicopathologic features, treatment, prognosis and prognostic factors of neuroendocrine carcinoma of the endometrium: a retrospective analysis of 42 cases from the Kansai Clinical Oncology Group/Intergroup study in Japan
复制标题
DOI：
10.3802/jgo.2019.30.e103
复制
发表时间：
2019-11-01
影响因子：
3.9
通讯作者：
Teramoto, Norihiro
中科院分区：
文献类型：
--
作者：
Matsumoto, Harunobu;Shimokawa, Mototsugu;Teramoto, Norihiro
目的：我们通过回顾性、多机构、协作研究积累子宫内膜神经内分泌癌病例，阐明其临床病理特征、治疗、预后及影响预后的因素，整理研究结果，以建立未来的个体化治疗方案。据我们所知，这是最大规模的病例研究，也是第一次对这种疾病的预后进行统计分析的研究。方法：在参加关西临床肿瘤学小组/Intergroup的医疗机构中，收集1995年至2014年在中央病理审查中诊断为子宫内膜神经内分泌癌的病例。我们回顾性分析了该疾病的临床病理特征、治疗、预后和影响预后的因素。其中，42例（64.6%）病例基于中心病理学审查被诊断为子宫内膜神经内分泌癌，因此被纳入研究。晚期国际妇产科联盟分期（III期和IV期）和纯型小细胞神经内分泌癌病例的预后明显较差。多因素分析显示，只有组织学亚型和手术是显著的预后因素。单纯型病例的预后明显差于混合型病例，完全手术病例的预后明显好于未手术或不完全手术的病例。结论：我们的研究结果表明，完全手术可改善子宫内膜神经内分泌癌的预后。即使在疾病晚期的病例中，如果预期可以实现完全手术，临床医生也应该考虑根治性手术，以改善子宫内膜神经内分泌癌的预后。
Objective: We conducted a retrospective, multi-institutional, collaborative study to accumulate cases of neuroendocrine carcinoma of the endometrium, to clarify its clinicopathologic features, treatment, prognosis and prognostic factors to collate findings to establish future individualized treatment regimens. To our knowledge, this is the largest case study and the first study to statistically analyze the prognosis of this disease.Methods: At medical institutions participating in the Kansai Clinical Oncology Group/Intergroup, cases diagnosed at a central pathologic review as neuroendocrine carcinoma of the endometrium between 1995 and 2014 were enrolled. We retrospectively analyzed the clinicopathologic features, treatment, prognosis and prognostic factors of this disease.Results: A total of 65 cases were registered from 18 medical institutions in Japan. Of these, 42 (64.6%) cases were diagnosed as neuroendocrine carcinoma of the endometrium based on the central pathological review and thus included in the study. Advanced International Federation of Gynecology and Obstetrics stages (stage III and IV) and pure type small cell neuroendocrine carcinoma cases had a significantly worse prognosis. Upon multivariate analysis, only histologic subtypes and surgery were significant prognostic factors. Pure type cases had a significantly worse prognosis compared to mixed type cases and complete surgery cases had a significantly better prognosis compared to cases with no or incomplete surgery.Conclusion: Our findings suggest that complete surgery improves the prognosis of neuroendocrine carcinoma of the endometrium. Even among cases with advanced disease stages, if complete surgery is expected to be achieved, clinicians should consider curative surgery to improve the prognosis of neuroendocrine carcinoma of the endometrium.