Prognostic Factors for Small Cell Neuroendocrine Carcinoma of the Uterine Cervix: An Institutional Experience

Intaraphet, Suthida; Kasatpibal, Nongyao; Siriaunkgul, Sumalee; Chandacham, Anchalee; Sukpan, Kornkanok; Patumanond, Jayanton

doi:10.1097/igc.0000000000000059

Cited by 35 publications

(34 citation statements)

References 22 publications

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“…These results must be interpreted cautiously given the low number of patients treated, but those are consistent with several reports, including a large database of 290 patients treated from 1977 to 2003, reporting that age, FIGO stage, tumor size, and LVI were prognostic factors. 1,19,25,26 The very high incidence of metastatic events encourages the development of novel systemic agents in order to improve patients' outcome, and based on a more thorough molecular characterization of disease.…”

Section: Discussionmentioning

confidence: 99%

Multimodal Management of Locally Advanced Neuroendocrine Cervical Carcinoma: A Single Institution Experience

Castelnau-Marchand¹,

Pautier²,

Genestie³

et al. 2018

Int J Gynecol Cancer

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Section: Discussionmentioning

confidence: 99%

Multimodal Management of Locally Advanced Neuroendocrine Cervical Carcinoma: A Single Institution Experience

Castelnau-Marchand¹,

Pautier²,

Genestie³

et al. 2018

Int J Gynecol Cancer

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“…Compared with squamous cell carcinoma (SCC) or adenocarcinoma (ADC) of the cervix, SCNEC is more likely to be an aggressive type that develops distant metastases, even in its early stages [2]. However, past studies have shown disagreement in the 5-year overall survival (OS) rate of SCNEC.…”

Section: Introductionmentioning

confidence: 96%

“…In addition to FIGO stage [6,7], several potential prognostic factors [2,[8][9][10][11][12][13][14] including age, tumor size, lymphovascular space involvement (LVSI), lymph node metastasis (LNM), depth of stromal invasion (DSI), parametrial involvement (PI), and treatment modality have been shown to influence survival, though not in all studies. For example, Lee et al [15] reported that in patients with stage IB-IIA SCNEC, neoadjuvant chemotherapy tended to improve 5-year survival.…”

Section: Introductionmentioning

confidence: 99%

Clinicopathological Aspects of Small Cell Neuroendocrine Carcinoma of the Uterine Cervix: a Multicenter Retrospective Study and Meta-Analysis

et al. 2018

Cell Physiol Biochem

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Background/Aims: To evaluate the clinicopathologic aspects of small cell neuroendocrine carcinoma of the uterine cervix (SCNEC). Methods: A retrospective review of 40 patients with SCNEC in 3 hospitals from 2009 to 2015 was conducted to assess the survival rates and examine the associations between clinicopathological variables and overall survival (OS). A meta-analysis of 22 studies containing 1901 patients was also conducted to further confirm the results. Results: In the clinical group of 40 patients, the 5-year OS rate was 20%. Advanced International Federation of Gynecology and Obstetrics (FIGO) stage and radiation therapy (RT) were associated with poor survival. However, radical surgery was associated with prolonged survival. In the meta-analysis of 1901 patients, the 2-year disease-free survival (DFS) rate, 5-year DFS rate, 2-year OS rate, 3-year OS rate and 5-year OS rate of SCNEC were 48%, 35%, 62%, 35%, and 35% respectively. Advanced FIGO stage, larger tumor size, lymph node metastasis (LNM) (+), lymphovascular space involvement (LVSI) (+), parametrial involvement (PI) (+), depth of stromal invasion (DSI) > 2/3, and RT were associated with poor survival. However, a chemotherapy regimen similar to that for small cell lung cancer was associated with prolonged survival. Conclusion: Advanced FIGO stage, larger tumor size, LNM (+), LVSI (+), DSI > 2/3, PI (+), and RT were independent predictors of poor prognosis of SCNEC. Radical surgery combined with a chemotherapy regimen similar to that of small cell lung cancer may be a potential therapeutic approach for SCNEC.

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“…Given its efficacy, it is believed that platinum-based chemotherapy has the capacity to improve overall survival or progression-free survival and should be used to treat NECUC patients including patients even with an early-stage disease. [23,24] Complying with this viewpoint, Zivanovic et al [25] demonstrated that platinum-based chemotherapy significantly increased 3-year distant recurrence-free survival rate for the stage IA1-IB2 patients of SCCC. Regimens containing cisplatin and etoposide have been considered to have a survival advantage over other therapeutic combinations in either small cell lung cancer (SCLC) [26,27] or SCCC.…”

Section: Discussionmentioning

confidence: 99%

Enhanced efficacy of adjuvant chemotherapy and radiotherapy in selected cases of surgically resected neuroendocrine carcinoma of the uterine cervix

Xie¹,

Song²,

Yang

et al. 2017

Medicine

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The aim of the present study is to identify the prognostic factors of overall survival and examine the effects of adjuvant chemotherapy and radiotherapy on the overall survival in neuroendocrine carcinoma of the uterine cervix (NECUC) patients.Forty-eight surgically treated patients were retrospectively recruited and clinicopathologic characteristics and treatments were reviewed. Kaplan–Meier product-limit method and Cox proportional-hazards regression were utilized for univariate and multivariate analyses.The median follow-up time was 20.6 months and the median overall survival was 30.7 months. The estimated 2-year and 5-year overall survival rates were 57.5% and 31.3%, respectively. Forty patients had ≤ stage IIA disease and 8 had >IIA disease. Univariate analysis identified the clinical stage ≤ IIA (P = 0.042), tumor size ≤ 4 cm (P = 0.005), negative lymph nodes metastasis (P < 0.001), depth of stromal invasion ≤ 1/2 (P = 0.001), negative parametrial involvement (P = 0.004), and weak staining of synaptophysin (P = 0.037), and chromogranin (P = 0.011) as the prognostic factors for an improved overall survival, while chemotherapy and radiotherapy were not prognostic factors in the whole cohort. However, surgery combined with chemotherapy and radiotherapy produced a survival advantage over surgery alone in patients with large tumors (P = 0.006). The combination of surgery and chemotherapy (with or without radiotherapy) did not show any significant difference in overall survival for small tumors (P = 0.816), compared with no chemotherapy (with or without radiotherapy). In addition, radiotherapy for tumors with squamous cell carcinoma or adenocarcinoma components achieved a better survival (P = 0.01), and there was a tendency of an unfavorable survival for radiotherapy in homogeneous carcinoma (P = 0.099). Tumor size was an independent prognostic factor in the multivariate analysis (HR: 12.724, 95% CI: 1.697–95.423, P = 0.013).In conclusion, clinicopathologic features significantly influence a NECUC patient's outcome. Tumor size and tumor histology can influence the effect of adjuvant chemotherapy and radiotherapy on overall survival. We recommend that platinum-based adjuvant chemotherapy should be used in all cases, while radiotherapy should be reserved for the selected NECUC patients whose tumors have mixed histology.

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Prognostic Factors for Small Cell Neuroendocrine Carcinoma of the Uterine Cervix: An Institutional Experience

Abstract: International Federation of Gynecology and Obstetrics stage, age at diagnosis, and deep stromal invasion were important prognostic factors for CSS in patients with SNEC. Adjuvant chemotherapy may provide survival benefits in surgically treated patients with early-stage SNEC.

Cited by 35 publications

References 22 publications

Multimodal Management of Locally Advanced Neuroendocrine Cervical Carcinoma: A Single Institution Experience

Multimodal Management of Locally Advanced Neuroendocrine Cervical Carcinoma: A Single Institution Experience

Clinicopathological Aspects of Small Cell Neuroendocrine Carcinoma of the Uterine Cervix: a Multicenter Retrospective Study and Meta-Analysis

Enhanced efficacy of adjuvant chemotherapy and radiotherapy in selected cases of surgically resected neuroendocrine carcinoma of the uterine cervix

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