Impact of the initial site of metastases on post-recurrence survival for neuroendocrine cervical cancer.
Impact of the initial site of metastases on post-recurrence survival for neuroendocrine cervical cancer.
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初始转移部位对神经内分泌宫颈癌复发后生存的影响
DOI：
10.1186/s12885-022-09737-4
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发表时间：
2022-06-14
期刊：
影响因子：
3.8
通讯作者：
中科院分区：
文献类型：
--
作者：
总结宫颈神经内分泌癌（NECC）复发的危险因素，强调复发部位对预后的重要性。我们招募了88名在2003年1月至2020年12月30日期间因病理学I-IVa期原发性NECC而在根治性手术后复发的患者，并根据初始复发将这些病例分为7组。采用Kaplan-Meier和考克斯回归分析影响术后复发生存率的危险因素。在88例NECC患者中，几乎所有患者（95.50%）均在3年内发生进展。肺复发患者的至疾病进展时间显著长于无肺复发患者（p = 0.008）。首次复发后，中位随访时间为11.1个月（范围2.37-65.50个月），5年PRS仅为20.6%。单因素分析显示，初次手术浸润深度、复发部位、腹腔脏器复发与PRS相关。多因素分析显示，复发部位的数量（p = 0.025）和腹部器官复发（p = 0.031）是独立的预后因素。值得注意的是，免疫检查点抑制剂和化疗的组合，有或没有手术，在复发性NECC中显示出43.8%的客观缓解率。腹部器官复发的患者需要更复杂的治疗。免疫治疗和化疗的联合应用可能为NECC的复发提供了机会。在线版本包含补充材料，可通过10.1186/s12885-022-09737-4获得。
To summarize the risk factors and emphasize the prognostic importance of the site of recurrent neuroendocrine cervical cancer (NECC). We enrolled 88 patients who developed recurrence after radical surgery for pathological stage I–IVa primary NECC between January 2003 and 30 December 2020 and classified these cases into 7 groups based on the initial recurrence. The risk factors for post-recurrence survival (PRS) were analyzed by Kaplan–Meier and Cox regression methods. Among 88 NECC patients, nearly all patients (95.50%) experienced progression within 3 years. The time to progression was significantly longer in patients with lung recurrence than in patients without lung recurrence (p = 0.008). After the first recurrence, the median follow-up was 11.1 months (range 2.37–65.50 months), and the 5-year PRS was only 20.6%. The depth of invasion in the primary surgery, number of recurrent sites, abdominal organ recurrence were correlated with PRS by univariate analysis. Multivariate analyses revealed that the number of recurrent sites (p = 0.025) and abdominal organ recurrence (p = 0.031) were independent prognostic factors. Notably, the combination of immune checkpoint inhibitors and chemotherapy, with or without surgery, showed a 43.8% objective response rate in recurrent NECC. Patients with abdominal organ recurrence need more sophisticated therapy. The combination of immune therapy and chemotherapy might be an opportunity for recurrent NECC. The online version contains supplementary material available at 10.1186/s12885-022-09737-4.
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影响因子：
82.9
作者：
Beltran H;Prandi D;Mosquera JM;Benelli M;Puca L;Cyrta J;Marotz C;Giannopoulou E;Chakravarthi BV;Varambally S;Tomlins SA;Nanus DM;Tagawa ST;Van Allen EM;Elemento O;Sboner A;Garraway LA;Rubin MA;Demichelis F
通讯作者：
Demichelis F
影响因子：
28.5
作者：
Ma W;Gilligan BM;Yuan J;Li T
通讯作者：
Li T
影响因子：
45.3
作者：
Lee, June-Koo;Lee, Junehawk;Ju, Young Seok
通讯作者：
Ju, Young Seok
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：
3.9
作者：
Li H;Wu X;Cheng X
通讯作者：
Cheng X