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Prognostic Factors of Surgically Treated Early-Stage Small Cell Neuroendocrine Carcinoma of the Cervix
  1. Lei Yuan, MD, PhD,
  2. Hongyuan Jiang, MD,
  3. Yin Lu, MD,
  4. Sun-wei Guo, PhD and
  5. Xishi Liu, MD, PhD
  1. Department of Gynecology, Obstetrics & Gynecology Hospital, Fudan University, Shanghai, China.
  1. Address correspondence and reprint requests to Xishi Liu, MD, PhD, Department of Gynecology, Obstetrics & Gynecology Hospital, Fudan University, 419 Fangxie Rd, Shanghai 200011, PR China. E-mail: xishiliu{at}163.com.

Abstract

Objective Small cell neuroendocrine carcinoma of the cervix (SCNECC) is a rare malignancy and has a high mortality despite of aggressive surgical treatment. The aims of this study were to determine the prognostic factors associated with the survival of surgically treated patients with early-stage SCNECC and to see whether carboplatin plus paclitaxel (TC) therapy after surgery can improve their survival.

Methods Thirty-eight women with FIGO stages IA2 (n = 1), IB1 (n = 31), IB2 (n = 3), and IIA1 (n = 3) were treated with radical hysterectomy, followed by adjuvant TC or non-TC, with or without radiotherapy, in our hospital between 2004 and 2013. Medical charts and clinical data were retrieved and retrospectively reviewed. The Kaplan-Meier method and Cox regression model were used for survival analysis.

Results The mean age of patients were 40.4 ± 7.0 years. The preoperative detection rate of SCNECC was only 34.2%. The overall 1-, 2-, and 5-year survival rate was 81.6%, 54.7%, and 43%, respectively, whereas the 1-, 2-, and 5-year cumulative recurrence rate was 37.8%, 44.2%, and 49.3%, respectively. For overall survival (OS), the univariate survival analysis indicated that tumor homology, parametrial invasion, chemotherapy regimens, and chemotherapy courses were risk factors. For disease-free survival, the univariate survival analysis identified lymph node involvement, tumor homology, parametrial invasion, chemotherapy regimens, and chemotherapy courses as risk factors. However, when multivariable Cox regression model was used, only parametrial invasion and postoperative chemotherapy regimen were identified as risk factors for both OS (P = 0.037 and P = 0.016) and disease-free survival (P = 0.044 and P = 0.018).

Conclusions Small cell neuroendocrine carcinoma of the cervix is a deadly variant of cervical cancer. Postoperative TC chemotherapy may improve the OS and disease-free survival in women with early-stage SCNECC.

  • Small cell neuroendocrine carcinoma of the cervix (SCNECC)
  • Prognosis
  • Chemotherapy

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Footnotes

  • Lei Yuan and Hongyuan Jiang contributed equally to this work.

  • Support: This project is sponsored by Shanghai Natural Science Fund (13ZR1451900 [Lei Yuan]).

  • The authors declare that there are no conflicts of interest.