title: Primary treatment and prognostic factors of small cell neuroendocrine carcinoma of the uterine cervix: a Taiwanese Gynecologic Oncology Group study.
abstract: BACKGROUND
  Our aims were to investigate the treatment and clinicopathological variables in relation to prognosis in small cell neuroendocrine cervical carcinoma (SCNECC).
  
  
  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.
authors.affiliation: Department of Obstetrics and Gynecology, Mackay Memorial Hospital and Mackay Medical College, Taipei, Taiwan.
authors.forename: Kung-Liahng
authors.initials: KL
authors.lastname: Wang
authors.forename: Ting-Chang
authors.initials: TC
authors.lastname: Chang
authors.forename: Shih-Ming
authors.initials: SM
authors.lastname: Jung
authors.forename: Chi-Hau
authors.initials: CH
authors.lastname: Chen
authors.forename: Ya-Min
authors.initials: YM
authors.lastname: Cheng
authors.forename: Hua-Hsi
authors.initials: HH
authors.lastname: Wu
authors.forename: Wen-Shiung
authors.initials: WS
authors.lastname: Liou
authors.forename: Shih-Tien
authors.initials: ST
authors.lastname: Hsu
authors.forename: Yu-Che
authors.initials: YC
authors.lastname: Ou
authors.forename: Lian-Shung
authors.initials: LS
authors.lastname: Yeh
authors.forename: Hung-Cheng
authors.initials: HC
authors.lastname: Lai
authors.forename: Chia-Yen
authors.initials: CY
authors.lastname: Huang
authors.forename: Tze-Chien
authors.initials: TC
authors.lastname: Chen
authors.forename: Chee-Jen
authors.initials: CJ
authors.lastname: Chang
authors.forename: Chyong-Huey
authors.initials: CH
authors.lastname: Lai
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018288:Carcinoma, Small Cell / Q000175:diagnosis* / Q000628:therapy*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D011379:Prognosis; D012042:Registries; D012189:Retrospective Studies; D013624:Taiwan; D013997:Time Factors; D016896:Treatment Outcome; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000628:therapy*