Prognostic factors and outcomes of early-stage small cell neuroendocrine carcinoma of the cervix: 37 cases from a single center

Dandan Zhang,Xiaoxin Ma

doi:10.7717/peerj.6868

Dandan Zhang, Xiaoxin Ma

Open Access

https://doi.org/10.7717/peerj.6868

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Journal: PeerJ	Publication Date: May 3, 2019
Citations: 7	License type: CC BY 4.0

Affiliation: China Medical University

Abstract

BackgroundThe objective of this study is to investigate small cell neuroendocrine carcinoma of the cervix (SCCC), using a retrospective clinicopathological characteristic and treatment approach.MethodWe retrospectively analyzed cases of early-stage SCCC, identified between 2006 and 2016, in women who received radical surgery and adjuvant chemotherapy with or without radiotherapy. Kaplan–Meier and one-way ANOVA analyses were performed.ResultA total of 37 cases of SCCC are presented in this study, of which 21 had stage IB1 SCCC, 12 had stage IB2, 3 had stage IIA1, and 1 had stage IIA2. All patients were treated with radical surgery and adjuvant chemotherapy, specifically, 26 with radical surgery followed by adjuvant chemotherapy plus radiation and 11 with neoadjuvant chemotherapy (NACT) followed by radical surgery. After a median follow-up time of 27 months (range, 8–115 months), the 2-year and 5-year disease-free survival rate for all patients was 51.9% and 34.1%, respectively, and the overall survival rate was 60.3% and 38.6%, respectively. Univariate analysis showed that International Federation of Gynecology and Obstetrics (FIGO) stage and tumor size may be a predictor of a poor prognosis. NACT and adjuvant radiation did not improve survival over adjuvant chemotherapy alone but should not be a significant independent prognostic factor for survival.ConclusionEven in patients with early-stage SCCC, the prognosis is poor, although FIGO stage and tumor size may act as surrogate factors prognostic of survival.

Highlights

Small-cell neuroendocrine carcinoma is a rare malignant tumor of the cervix (SCCC), accounting for 0.5–1% of all cervical cancer (Morris et al, 1992)
Epidemiological studies have shown that small cell neuroendocrine carcinoma of the cervix (SCCC) accounts for an incidence of only 1–3% of cervical cancer cases (Tsunoda et al, 2005; Crowder & Tuller 2007); the high degree of invasiveness and early distant metastasis leads to a poor prognosis at the time of the diagnosis of SCCC (Chan et al, 2003; Viswanathan et al, 2004)
International Federation of Gynecology and Obstetrics stage, large tumor size, LNM, deep cervical stromal invasion, smoking, and pure small-cell histology are always suggested as indicators of a poor prognosis in SCCC (Xie et al, 2017; Zhou et al, 2016)

Summary

Introduction

Small-cell neuroendocrine carcinoma is a rare malignant tumor of the cervix (SCCC), accounting for 0.5–1% of all cervical cancer (Morris et al, 1992). It is characterized by early nodal and distant metastases, resulting in a poor prognosis (Miller et al, 1991). Prognostic factors and outcomes of early-stage small cell neuroendocrine carcinoma of the cervix: 37 cases from a single center. The objective of this study is to investigate small cell neuroendocrine carcinoma of the cervix (SCCC), using a retrospective clinicopathological characteristic and treatment approach. Conclusion: Even in patients with early-stage SCCC, the prognosis is poor, FIGO stage and tumor size may act as surrogate factors prognostic of survival

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