A multi-center retrospective study of neuroendocrine tumors of the uterine cervix: Prognosis according to the new 2018 staging system, comparing outcomes for different chemotherapeutic regimens and histopathological subtypes

Autor: Tsutomu Miyamoto, Shoji Kodama, Takafumi Inoue, Mitsuya Ishikawa, Nobuo Yaegashi, Yoshinari Matsumoto, Kayo Suzuki, Kazuaki Takahashi, Takahide Arimoto, Kazuya Ariyoshi, Masaharu Fukunaga, Tsunehisa Kaku, Takayo Kawabata, Atsuhiko Sakamoto, Hitoshi Tsuda, Takahiro Kasamatsu, Masashi Takano, Tatsuya Kato, Hidekatsu Nakai, Masatoshi Yokoyama
Rok vydání: 2019
Předmět:
Zdroj: Gynecologic Oncology. 155:444-451
ISSN: 0090-8258
DOI: 10.1016/j.ygyno.2019.09.018
Popis: To analyze the clinical behavior of neuroendocrine tumors (NETs) of the uterine cervix, we conducted a multicenter, retrospective study of 193 patients.We evaluated the prognosis of NETs according to the new International Federation of Gynecology and Obstetrics (FIGO) staging system, compared the clinical response to different chemotherapy regimens, and compared different histological subtypes of NETS.Diagnoses of the subjects were atypical carcinoid tumor (ACT, n = 37), small cell neuroendocrine carcinoma (SCNEC, n = 126), large cell neuroendocrine carcinoma (LCNEC, n = 22), and NET, not elsewhere classified (n = 8), according to central pathological review. According to FIGO 2018, 69, 17, 74, and 33 patients were at stage I, II, III, or IV, respectively. Five-year survival was 64.5%, 50.1%, 30.2%, and 3.4% for patients at stage I, II, III and IV. About 40% of patients with stage IIIC1 survived5 years. On multivariate analyses, locally-advanced disease, para-aortic node metastasis, distant metastasis, and4 cycles of chemotherapy were associated with poor survival. Histological subtype and pelvic node metastasis had no prognostic significance. Response rates to etoposide-platinum (EP) or irinotecan-platinum (CPT-P) regimens were 43.8% (28/64), but only 12.9% to a taxane-platinum (TC) regimen (4/31). The response rate for ACT was 8.7% (2/23), significantly less than the 36.6% for high-grade neuroendocrine carcinomas (HGNEC: both SCNEC and LCNEC, 41/111).Locally-advanced, extra-pelvic disease and insufficient chemotherapy were independent prognostic factors for cervical NET. HGNEC showed good responses to EP or CPT-P but not TC. Chemotherapy was less effective for ACT, which had a prognosis identical to HGNEC.
Databáze: OpenAIRE
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