Prognostic factors in FIGO stage IB-IIA small cell neuroendocrine carcinoma of the uterine cervix treated surgically: results of a multi-center retrospective Korean study
- J.-M. Lee; K.-B. Lee; J.-H. Nam; S.-Y. Ryu; D.-S. Bae; J.-T. Park; S.-C. Kim; S.-D. Cha; K.-R. Kim; S.-Y. Song; S.-B. Kang
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- Background: To determine the clinical and pathologic prognostic factors in surgically treated patients with
International Federation of Gynecology and Obstetrics (FIGO) stage IB–IIA small cell neuroendocrine carcinoma of the
uterine cervix (SCNEC).
Patients and methods: We retrospectively reviewed a total of 68 patients with FIGO stage IB–IIA SCNEC surgically
treated from January 1997 to December 2003 in Korea.
Results: Of the 68 patients, 43 had FIGO stage IB1 SCNEC, 15 had stage IB2, and 10 had stage IIA. Seven were
treated with radical surgery alone; 11 with neoadjuvant chemotherapy (NACT) followed by radical surgery; 24 with
radical surgery followed by adjuvant chemotherapy; and 26 with radical surgery followed by adjuvant radiation or
chemoradiation. After a median follow-up of 44 months (range, 6–113 months), the 2-year and 5-year survival rates for
all patients were 64.6% and 46.6%, respectively. Univariate and multivariate analysis showed that FIGO stage was
predictive of poor prognosis. Patients who received NACT showed poorer prognosis than those who did not receive
NACT. Adjuvant chemoradiation did not improve survival compared with adjuvant chemotherapy alone.
Conclusions: FIGO stage may act as a surrogate for factors prognostic of survival. Primary radical surgery followed
by adjuvant chemotherapy is the preferred treatment modality for patients with early stage SCNEC.
Key words: neuroendocrine carcinoma, prognosis, small cell, uterine cervix
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