title: Prognostic Factors of Surgically Treated Early-Stage Small Cell Neuroendocrine Carcinoma of the Cervix.
abstract: OBJECTIVE
  Small cell neuroendocrine carcinoma of the cervix (SCNECC) is a rare malignancy and has a high mortality despite of aggressive surgical treatment. The aims of this study were to determine the prognostic factors associated with the survival of surgically treated patients with early-stage SCNECC and to see whether carboplatin plus paclitaxel (TC) therapy after surgery can improve their survival.
  
  
  METHODS
  Thirty-eight women with FIGO stages IA2 (n = 1), IB1 (n = 31), IB2 (n = 3), and IIA1 (n = 3) were treated with radical hysterectomy, followed by adjuvant TC or non-TC, with or without radiotherapy, in our hospital between 2004 and 2013. Medical charts and clinical data were retrieved and retrospectively reviewed. The Kaplan-Meier method and Cox regression model were used for survival analysis.
  
  
  RESULTS
  The mean age of patients were 40.4 ± 7.0 years. The preoperative detection rate of SCNECC was only 34.2%. The overall 1-, 2-, and 5-year survival rate was 81.6%, 54.7%, and 43%, respectively, whereas the 1-, 2-, and 5-year cumulative recurrence rate was 37.8%, 44.2%, and 49.3%, respectively. For overall survival (OS), the univariate survival analysis indicated that tumor homology, parametrial invasion, chemotherapy regimens, and chemotherapy courses were risk factors. For disease-free survival, the univariate survival analysis identified lymph node involvement, tumor homology, parametrial invasion, chemotherapy regimens, and chemotherapy courses as risk factors. However, when multivariable Cox regression model was used, only parametrial invasion and postoperative chemotherapy regimen were identified as risk factors for both OS (P = 0.037 and P = 0.016) and disease-free survival (P = 0.044 and P = 0.018).
  
  
  CONCLUSIONS
  Small cell neuroendocrine carcinoma of the cervix is a deadly variant of cervical cancer. Postoperative TC chemotherapy may improve the OS and disease-free survival in women with early-stage SCNECC.
authors.affiliation: Department of Gynecology, Obstetrics & Gynecology Hospital, Fudan University, Shanghai, China.
authors.forename: Lei
authors.initials: L
authors.lastname: Yuan
authors.forename: Hongyuan
authors.initials: H
authors.lastname: Jiang
authors.forename: Yin
authors.initials: Y
authors.lastname: Lu
authors.forename: Sun-Wei
authors.initials: SW
authors.lastname: Guo
authors.forename: Xishi
authors.initials: X
authors.lastname: Liu
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018278:Carcinoma, Neuroendocrine / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D018288:Carcinoma, Small Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D002294:Carcinoma, Squamous Cell / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007044:Hysterectomy / Q000401:mortality*; D008197:Lymph Node Excision; D009367:Neoplasm Staging; D011379:Prognosis; D015996:Survival Rate; D002583:Uterine Cervical Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery