Prognostic factors and optimal therapy for stages I–II neuroendocrine carcinomas of the uterine cervix: A multi-center retrospective study

Mitsuya Ishikawa, Takahiro Kasamatsu, Hitoshi Tsuda, Masaharu Fukunaga, Atsuhiko Sakamoto, Tsunehisa Kaku, Toru Nakanishi, Yoko Hasumi, Takashi Iwata, Tsukasa Baba, Takayoshi Nogawa, Wataru Kudaka, Hiroshi Kaneda, Shigemitsu Ono, Fumitaka Saito, Yoshimi Taniguchi, Satoshi Okada, Mika Mizuno, Takashi Onda, Nobuo Yaegashi

研究成果: Article査読

21 被引用数 (Scopus)

抄録

Purpose We aimed to determine appropriate treatment guidelines for patients with stages I–II high-grade neuroendocrine carcinomas (HGNEC) of the uterine cervix in a multicenter retrospective study. Patients and methods We reviewed the clinicopathological features and prognoses of 93 patients with HGNEC of International Federation of Gynecology and Obstetrics (FIGO) stages I and II. All patients were diagnosed with HGNEC by central pathological review. Results The median overall survival (OS) and disease-free survival (DFS) were 111.3 months and 47.4 months, respectively. Eighty-eight patients underwent radical surgery, and five had definitive radiotherapy. The hazard ratio (HR) for death after definitive radiotherapy to death after radical surgery was 4.74 (95% confidence interval [CI], 1.01–15.90). Of the surgery group, 18 received neoadjuvant chemotherapy. Pathological prognostic factors and optimal adjuvant therapies were evaluated for the 70 patients. Forty-one patients received adjuvant chemotherapy with etoposide–platinum (EP) or irinotecan–platinum (CPT–P). Multivariate analyses identified the invasion of lymphovascular spaces as a significant prognostic factor for both OS and DFS. Pelvic lymph node metastasis was also a prognostic factor for DFS. Adjuvant chemotherapy with an EP or CPT–P regimen appeared to improve DFS (HR = 0.27, 95% CI, 0.10–0.69). A trend toward improved OS was also observed, but was not statistically significant (HR = 0.39, 95% CI, 0.15–1.01). Conclusion Radical surgery followed by adjuvant chemotherapy with an EP or CPT–P regimen was optimal treatment for stages I and II HGNEC of the uterine cervix.

本文言語English
ページ(範囲)139-146
ページ数8
ジャーナルGynecologic Oncology
148
1
DOI
出版ステータスPublished - 2018 1月

ASJC Scopus subject areas

  • 腫瘍学
  • 産婦人科学

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