Primary treatment and prognostic factors of small cell neuroendocrine carcinoma of the uterine cervix: A Taiwanese Gynecologic Oncology Group study

Kung Liahng Wang, Ting Chang Chang, Shih Ming Jung, Chi Hau Chen, Ya Min Cheng, Hua Hsi Wu, Wen Shiung Liou, Shih Tien Hsu, Yu Che Ou, Lian Shung Yeh, Hung Cheng Lai, Chia Yen Huang, Tze Chien Chen, Chee Jen Chang, Chyong Huey Lai

Research output: Contribution to journalArticle

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Abstract

Background: Our aims were to investigate the treatment and clinicopathological variables in relation to prognosis in small cell neuroendocrine cervical carcinoma (SCNECC). Patients and methods: Clinical data of SCNECC patients with International Federation of Gynaecology and Obstetrics (FIGO) stages I-IV treated between 1987 and 2009 at member hospitals of the Taiwanese Gynecologic Oncology Group (TGOG) were retrospectively reviewed. Results: Of the 179 eligible patients, 104 were of FIGO stage I, 19 stage IIA, 23 stage IIB, 9 stage III, and 24 stage IV. The median failure-free survival (FFS) was 16.0 months, and the median cancer-specific survival (CSS) was 24.8 months. In multivariate analysis, FIGO stage and lymph node metastasis were selected as independent variables in stages I-IV. In stages IIB-IVB, primary treatment containing etoposide and platinum for at least 5 cycles (EP5+) (n = 16) was associated with significantly better 5-year FFS (42.9% versus 11.8%, p = 0.041) and CSS (45.6% versus 17.1%, p = 0.035) compared to other treatments (n = 40). Furthermore, concurrent chemoradiation with EP5+ (CCRT-EP5+) was associated with even better 5-year FFS (62.5% versus 13.1%, p = 0.025) and CSS (75.0% versus 16.9%, p = 0.016). Conclusions: FIGO stage and lymph node metastasis are significant prognostic factors in SCNECC. In stages IIB-IVB, CCRT-EP5+ might be the treatment of choice, which could be also true for earlier stages. Despite limitations of a retrospective study spanning a long time period and heterogeneous managements, the results provide an important basis for designing future prospective studies.

Original languageEnglish
Pages (from-to)1484-1494
Number of pages11
JournalEuropean Journal of Cancer
Volume48
Issue number10
DOIs
Publication statusPublished - Jul 2012
Externally publishedYes

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Neuroendocrine Carcinoma
Small Cell Carcinoma
Cervix Uteri
Gynecology
Obstetrics
Survival
Therapeutics
Lymph Nodes
Neoplasm Metastasis
Neoplasms
Etoposide
Platinum
Multivariate Analysis
Retrospective Studies
Prospective Studies

Keywords

  • Cervical carcinoma
  • Chemoradiation
  • Chemotherapy
  • Prognosis
  • Small cell neuroendocrine carcinoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Primary treatment and prognostic factors of small cell neuroendocrine carcinoma of the uterine cervix : A Taiwanese Gynecologic Oncology Group study. / Wang, Kung Liahng; Chang, Ting Chang; Jung, Shih Ming; Chen, Chi Hau; Cheng, Ya Min; Wu, Hua Hsi; Liou, Wen Shiung; Hsu, Shih Tien; Ou, Yu Che; Yeh, Lian Shung; Lai, Hung Cheng; Huang, Chia Yen; Chen, Tze Chien; Chang, Chee Jen; Lai, Chyong Huey.

In: European Journal of Cancer, Vol. 48, No. 10, 07.2012, p. 1484-1494.

Research output: Contribution to journalArticle

Wang, KL, Chang, TC, Jung, SM, Chen, CH, Cheng, YM, Wu, HH, Liou, WS, Hsu, ST, Ou, YC, Yeh, LS, Lai, HC, Huang, CY, Chen, TC, Chang, CJ & Lai, CH 2012, 'Primary treatment and prognostic factors of small cell neuroendocrine carcinoma of the uterine cervix: A Taiwanese Gynecologic Oncology Group study', European Journal of Cancer, vol. 48, no. 10, pp. 1484-1494. https://doi.org/10.1016/j.ejca.2011.12.014
Wang, Kung Liahng ; Chang, Ting Chang ; Jung, Shih Ming ; Chen, Chi Hau ; Cheng, Ya Min ; Wu, Hua Hsi ; Liou, Wen Shiung ; Hsu, Shih Tien ; Ou, Yu Che ; Yeh, Lian Shung ; Lai, Hung Cheng ; Huang, Chia Yen ; Chen, Tze Chien ; Chang, Chee Jen ; Lai, Chyong Huey. / Primary treatment and prognostic factors of small cell neuroendocrine carcinoma of the uterine cervix : A Taiwanese Gynecologic Oncology Group study. In: European Journal of Cancer. 2012 ; Vol. 48, No. 10. pp. 1484-1494.
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abstract = "Background: Our aims were to investigate the treatment and clinicopathological variables in relation to prognosis in small cell neuroendocrine cervical carcinoma (SCNECC). Patients and methods: Clinical data of SCNECC patients with International Federation of Gynaecology and Obstetrics (FIGO) stages I-IV treated between 1987 and 2009 at member hospitals of the Taiwanese Gynecologic Oncology Group (TGOG) were retrospectively reviewed. Results: Of the 179 eligible patients, 104 were of FIGO stage I, 19 stage IIA, 23 stage IIB, 9 stage III, and 24 stage IV. The median failure-free survival (FFS) was 16.0 months, and the median cancer-specific survival (CSS) was 24.8 months. In multivariate analysis, FIGO stage and lymph node metastasis were selected as independent variables in stages I-IV. In stages IIB-IVB, primary treatment containing etoposide and platinum for at least 5 cycles (EP5+) (n = 16) was associated with significantly better 5-year FFS (42.9{\%} versus 11.8{\%}, p = 0.041) and CSS (45.6{\%} versus 17.1{\%}, p = 0.035) compared to other treatments (n = 40). Furthermore, concurrent chemoradiation with EP5+ (CCRT-EP5+) was associated with even better 5-year FFS (62.5{\%} versus 13.1{\%}, p = 0.025) and CSS (75.0{\%} versus 16.9{\%}, p = 0.016). Conclusions: FIGO stage and lymph node metastasis are significant prognostic factors in SCNECC. In stages IIB-IVB, CCRT-EP5+ might be the treatment of choice, which could be also true for earlier stages. Despite limitations of a retrospective study spanning a long time period and heterogeneous managements, the results provide an important basis for designing future prospective studies.",
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T2 - A Taiwanese Gynecologic Oncology Group study

AU - Wang, Kung Liahng

AU - Chang, Ting Chang

AU - Jung, Shih Ming

AU - Chen, Chi Hau

AU - Cheng, Ya Min

AU - Wu, Hua Hsi

AU - Liou, Wen Shiung

AU - Hsu, Shih Tien

AU - Ou, Yu Che

AU - Yeh, Lian Shung

AU - Lai, Hung Cheng

AU - Huang, Chia Yen

AU - Chen, Tze Chien

AU - Chang, Chee Jen

AU - Lai, Chyong Huey

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N2 - Background: Our aims were to investigate the treatment and clinicopathological variables in relation to prognosis in small cell neuroendocrine cervical carcinoma (SCNECC). Patients and methods: Clinical data of SCNECC patients with International Federation of Gynaecology and Obstetrics (FIGO) stages I-IV treated between 1987 and 2009 at member hospitals of the Taiwanese Gynecologic Oncology Group (TGOG) were retrospectively reviewed. Results: Of the 179 eligible patients, 104 were of FIGO stage I, 19 stage IIA, 23 stage IIB, 9 stage III, and 24 stage IV. The median failure-free survival (FFS) was 16.0 months, and the median cancer-specific survival (CSS) was 24.8 months. In multivariate analysis, FIGO stage and lymph node metastasis were selected as independent variables in stages I-IV. In stages IIB-IVB, primary treatment containing etoposide and platinum for at least 5 cycles (EP5+) (n = 16) was associated with significantly better 5-year FFS (42.9% versus 11.8%, p = 0.041) and CSS (45.6% versus 17.1%, p = 0.035) compared to other treatments (n = 40). Furthermore, concurrent chemoradiation with EP5+ (CCRT-EP5+) was associated with even better 5-year FFS (62.5% versus 13.1%, p = 0.025) and CSS (75.0% versus 16.9%, p = 0.016). Conclusions: FIGO stage and lymph node metastasis are significant prognostic factors in SCNECC. In stages IIB-IVB, CCRT-EP5+ might be the treatment of choice, which could be also true for earlier stages. Despite limitations of a retrospective study spanning a long time period and heterogeneous managements, the results provide an important basis for designing future prospective studies.

AB - Background: Our aims were to investigate the treatment and clinicopathological variables in relation to prognosis in small cell neuroendocrine cervical carcinoma (SCNECC). Patients and methods: Clinical data of SCNECC patients with International Federation of Gynaecology and Obstetrics (FIGO) stages I-IV treated between 1987 and 2009 at member hospitals of the Taiwanese Gynecologic Oncology Group (TGOG) were retrospectively reviewed. Results: Of the 179 eligible patients, 104 were of FIGO stage I, 19 stage IIA, 23 stage IIB, 9 stage III, and 24 stage IV. The median failure-free survival (FFS) was 16.0 months, and the median cancer-specific survival (CSS) was 24.8 months. In multivariate analysis, FIGO stage and lymph node metastasis were selected as independent variables in stages I-IV. In stages IIB-IVB, primary treatment containing etoposide and platinum for at least 5 cycles (EP5+) (n = 16) was associated with significantly better 5-year FFS (42.9% versus 11.8%, p = 0.041) and CSS (45.6% versus 17.1%, p = 0.035) compared to other treatments (n = 40). Furthermore, concurrent chemoradiation with EP5+ (CCRT-EP5+) was associated with even better 5-year FFS (62.5% versus 13.1%, p = 0.025) and CSS (75.0% versus 16.9%, p = 0.016). Conclusions: FIGO stage and lymph node metastasis are significant prognostic factors in SCNECC. In stages IIB-IVB, CCRT-EP5+ might be the treatment of choice, which could be also true for earlier stages. Despite limitations of a retrospective study spanning a long time period and heterogeneous managements, the results provide an important basis for designing future prospective studies.

KW - Cervical carcinoma

KW - Chemoradiation

KW - Chemotherapy

KW - Prognosis

KW - Small cell neuroendocrine carcinoma

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