A Multicenter Study of the Importance of Systemic Chemotherapy for Patients with Small-Cell Neuroendocrine Carcinoma of the Uterine Cervix

作者：Lee Shin Wha; Lim Kyung Taek; Bae Duk Soo; Park Sang Yoon; Kim Young Tae; Kim Kyu Rae; Nam Joo Hyun^*

来源：Gynecologic and Obstetric Investigation, 2015, 79(3): 172-178.

DOI：10.1159/000367920

• Small-cell carcinoma
• Neuroendocrine carcinoma
• Cervical cancer
• Chemotherapy

Aims: We investigated the prognosis of patients with small-cell neuroendocrine carcinoma of the uterine cervix (SCNEC) in relation to treatment modalities. Methods: We retrospectively reviewed the medical records and pathological reports of 102 patients who were histologically diagnosed with SCNEC at 5 different institutes. Time to progression (TTP) and overall survival (OS) were analyzed for each treatment modality. Results: Of the patients with early-stage [International Federation of Obstetrics and Gynecology (FIGO) stage IB2 or below] SCNEC, 57.8 and 79.3% underwent radical hysterectomy followed by adjuvant therapy. In advanced-stage SCNEC, concurrent chemoradiation therapy was given to 51.4% of the patients. The overall recurrence rate was 51.6%. In early- and advanced-stage SCNEC, the TIP was not different (22.3 vs. 13.3 months, p = 0.104), but the OS was different (40.7 vs. 21.4 months, p = 0.029). Parametrial involvement and lymph vascular space invasion were found to be associated with an unfavorable prognosis. Interestingly, survival was the most unfavorable in patients with early-stage SCNEC who had never received chemotherapy. FIGO stage and use of chemotherapy were identified as independent prognostic factors in SCNEC patients. Conclusions: SCNEC requires systemic chemotherapy as part of the initial treatment, along with surgery or radiation, even in patients with early-stage disease.

• 出版日期2015