title: A multicenter study of the importance of systemic chemotherapy for patients with small-cell neuroendocrine carcinoma of the uterine cervix.
abstract: OBJECTIVE
  We investigated the prognosis of patients with small-cell neuroendocrine carcinoma of the uterine cervix (SCNEC) in relation to treatment modalities.
  
  
  METHODS
  We retrospectively reviewed the medical records and pathological reports of 102 patients who were histologically diagnosed with SCNEC at 5 different institutes. Time to progression (TTP) and overall survival (OS) were analyzed for each treatment modality.
  
  
  RESULTS
  Of the patients with early-stage [International Federation of Obstetrics and Gynecology (FIGO) stage IB2 or below] SCNEC, 57.8 and 79.3% underwent radical hysterectomy followed by adjuvant therapy. In advanced-stage SCNEC, concurrent chemoradiation therapy was given to 51.4% of the patients. The overall recurrence rate was 51.6%. In early- and advanced-stage SCNEC, the TTP was not different (22.3 vs. 13.3 months, p = 0.104), but the OS was different (40.7 vs. 21.4 months, p = 0.029). Parametrial involvement and lymph vascular space invasion were found to be associated with an unfavorable prognosis. Interestingly, survival was the most unfavorable in patients with early-stage SCNEC who had never received chemotherapy. FIGO stage and use of chemotherapy were identified as independent prognostic factors in SCNEC patients.
  
  
  CONCLUSIONS
  SCNEC requires systemic chemotherapy as part of the initial treatment, along with surgery or radiation, even in patients with early-stage disease.
authors.affiliation: Department of Obstetrics and Gynecology, Asan Medical Center, University of Ulsan, Seoul, Korea.
authors.forename: Shin-Wha
authors.initials: SW
authors.lastname: Lee
authors.forename: Kyung-Taek
authors.initials: KT
authors.lastname: Lim
authors.forename: Duk Soo
authors.initials: DS
authors.lastname: Bae
authors.forename: Sang Yoon
authors.initials: SY
authors.lastname: Park
authors.forename: Young Tae
authors.initials: YT
authors.lastname: Kim
authors.forename: Kyu-Rae
authors.initials: KR
authors.lastname: Kim
authors.forename: Joo-Hyun
authors.initials: JH
authors.lastname: Nam
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018278:Carcinoma, Neuroendocrine / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D018288:Carcinoma, Small Cell / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D002584:Cervix Uteri / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018450:Disease Progression; D005260:Female; D006801:Humans; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D016019:Survival Analysis; D002583:Uterine Cervical Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*