Prognostic factors and optimal therapy for stages I–II neuroendocrine carcinomas of the uterine cervix: A multi-center retrospective study

Mitsuya Ishikawa, Takahiro Kasamatsu, Hitoshi Tsuda, Masaharu Fukunaga, Atsuhiko Sakamoto, Tsunehisa Kaku, Toru Nakanishi, Yoko Hasumi, Takashi Iwata, Tsukasa Baba, Takayoshi Nogawa, Wataru Kudaka, Hiroshi Kaneda, Shigemitsu Ono, Fumitaka Saito, Yoshimi Taniguchi, Satoshi Okada, Mika Mizuno, Takashi Onda, Nobuo Yaegashi

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Abstract

Purpose We aimed to determine appropriate treatment guidelines for patients with stages I–II high-grade neuroendocrine carcinomas (HGNEC) of the uterine cervix in a multicenter retrospective study. Patients and methods We reviewed the clinicopathological features and prognoses of 93 patients with HGNEC of International Federation of Gynecology and Obstetrics (FIGO) stages I and II. All patients were diagnosed with HGNEC by central pathological review. Results The median overall survival (OS) and disease-free survival (DFS) were 111.3 months and 47.4 months, respectively. Eighty-eight patients underwent radical surgery, and five had definitive radiotherapy. The hazard ratio (HR) for death after definitive radiotherapy to death after radical surgery was 4.74 (95% confidence interval [CI], 1.01–15.90). Of the surgery group, 18 received neoadjuvant chemotherapy. Pathological prognostic factors and optimal adjuvant therapies were evaluated for the 70 patients. Forty-one patients received adjuvant chemotherapy with etoposide–platinum (EP) or irinotecan–platinum (CPT–P). Multivariate analyses identified the invasion of lymphovascular spaces as a significant prognostic factor for both OS and DFS. Pelvic lymph node metastasis was also a prognostic factor for DFS. Adjuvant chemotherapy with an EP or CPT–P regimen appeared to improve DFS (HR = 0.27, 95% CI, 0.10–0.69). A trend toward improved OS was also observed, but was not statistically significant (HR = 0.39, 95% CI, 0.15–1.01). Conclusion Radical surgery followed by adjuvant chemotherapy with an EP or CPT–P regimen was optimal treatment for stages I and II HGNEC of the uterine cervix.

Original languageEnglish
Pages (from-to)139-146
Number of pages8
JournalGynecologic Oncology
Volume148
Issue number1
DOIs
Publication statusPublished - Jan 1 2018

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Neuroendocrine Carcinoma
Cervix Uteri
Retrospective Studies
Disease-Free Survival
Adjuvant Chemotherapy
Confidence Intervals
Therapeutics
Survival
Radiotherapy
Gynecology
Obstetrics
Multicenter Studies
Multivariate Analysis
Lymph Nodes
Guidelines
Neoplasm Metastasis
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Oncology
  • Obstetrics and Gynaecology

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Prognostic factors and optimal therapy for stages I–II neuroendocrine carcinomas of the uterine cervix : A multi-center retrospective study. / Ishikawa, Mitsuya; Kasamatsu, Takahiro; Tsuda, Hitoshi; Fukunaga, Masaharu; Sakamoto, Atsuhiko; Kaku, Tsunehisa; Nakanishi, Toru; Hasumi, Yoko; Iwata, Takashi; Baba, Tsukasa; Nogawa, Takayoshi; Kudaka, Wataru; Kaneda, Hiroshi; Ono, Shigemitsu; Saito, Fumitaka; Taniguchi, Yoshimi; Okada, Satoshi; Mizuno, Mika; Onda, Takashi; Yaegashi, Nobuo.

In: Gynecologic Oncology, Vol. 148, No. 1, 01.01.2018, p. 139-146.

Research output: Contribution to journalArticle

Ishikawa, M, Kasamatsu, T, Tsuda, H, Fukunaga, M, Sakamoto, A, Kaku, T, Nakanishi, T, Hasumi, Y, Iwata, T, Baba, T, Nogawa, T, Kudaka, W, Kaneda, H, Ono, S, Saito, F, Taniguchi, Y, Okada, S, Mizuno, M, Onda, T & Yaegashi, N 2018, 'Prognostic factors and optimal therapy for stages I–II neuroendocrine carcinomas of the uterine cervix: A multi-center retrospective study', Gynecologic Oncology, vol. 148, no. 1, pp. 139-146. https://doi.org/10.1016/j.ygyno.2017.10.027
Ishikawa, Mitsuya ; Kasamatsu, Takahiro ; Tsuda, Hitoshi ; Fukunaga, Masaharu ; Sakamoto, Atsuhiko ; Kaku, Tsunehisa ; Nakanishi, Toru ; Hasumi, Yoko ; Iwata, Takashi ; Baba, Tsukasa ; Nogawa, Takayoshi ; Kudaka, Wataru ; Kaneda, Hiroshi ; Ono, Shigemitsu ; Saito, Fumitaka ; Taniguchi, Yoshimi ; Okada, Satoshi ; Mizuno, Mika ; Onda, Takashi ; Yaegashi, Nobuo. / Prognostic factors and optimal therapy for stages I–II neuroendocrine carcinomas of the uterine cervix : A multi-center retrospective study. In: Gynecologic Oncology. 2018 ; Vol. 148, No. 1. pp. 139-146.
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abstract = "Purpose We aimed to determine appropriate treatment guidelines for patients with stages I–II high-grade neuroendocrine carcinomas (HGNEC) of the uterine cervix in a multicenter retrospective study. Patients and methods We reviewed the clinicopathological features and prognoses of 93 patients with HGNEC of International Federation of Gynecology and Obstetrics (FIGO) stages I and II. All patients were diagnosed with HGNEC by central pathological review. Results The median overall survival (OS) and disease-free survival (DFS) were 111.3 months and 47.4 months, respectively. Eighty-eight patients underwent radical surgery, and five had definitive radiotherapy. The hazard ratio (HR) for death after definitive radiotherapy to death after radical surgery was 4.74 (95{\%} confidence interval [CI], 1.01–15.90). Of the surgery group, 18 received neoadjuvant chemotherapy. Pathological prognostic factors and optimal adjuvant therapies were evaluated for the 70 patients. Forty-one patients received adjuvant chemotherapy with etoposide–platinum (EP) or irinotecan–platinum (CPT–P). Multivariate analyses identified the invasion of lymphovascular spaces as a significant prognostic factor for both OS and DFS. Pelvic lymph node metastasis was also a prognostic factor for DFS. Adjuvant chemotherapy with an EP or CPT–P regimen appeared to improve DFS (HR = 0.27, 95{\%} CI, 0.10–0.69). A trend toward improved OS was also observed, but was not statistically significant (HR = 0.39, 95{\%} CI, 0.15–1.01). Conclusion Radical surgery followed by adjuvant chemotherapy with an EP or CPT–P regimen was optimal treatment for stages I and II HGNEC of the uterine cervix.",
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T1 - Prognostic factors and optimal therapy for stages I–II neuroendocrine carcinomas of the uterine cervix

T2 - A multi-center retrospective study

AU - Ishikawa, Mitsuya

AU - Kasamatsu, Takahiro

AU - Tsuda, Hitoshi

AU - Fukunaga, Masaharu

AU - Sakamoto, Atsuhiko

AU - Kaku, Tsunehisa

AU - Nakanishi, Toru

AU - Hasumi, Yoko

AU - Iwata, Takashi

AU - Baba, Tsukasa

AU - Nogawa, Takayoshi

AU - Kudaka, Wataru

AU - Kaneda, Hiroshi

AU - Ono, Shigemitsu

AU - Saito, Fumitaka

AU - Taniguchi, Yoshimi

AU - Okada, Satoshi

AU - Mizuno, Mika

AU - Onda, Takashi

AU - Yaegashi, Nobuo

PY - 2018/1/1

Y1 - 2018/1/1

N2 - Purpose We aimed to determine appropriate treatment guidelines for patients with stages I–II high-grade neuroendocrine carcinomas (HGNEC) of the uterine cervix in a multicenter retrospective study. Patients and methods We reviewed the clinicopathological features and prognoses of 93 patients with HGNEC of International Federation of Gynecology and Obstetrics (FIGO) stages I and II. All patients were diagnosed with HGNEC by central pathological review. Results The median overall survival (OS) and disease-free survival (DFS) were 111.3 months and 47.4 months, respectively. Eighty-eight patients underwent radical surgery, and five had definitive radiotherapy. The hazard ratio (HR) for death after definitive radiotherapy to death after radical surgery was 4.74 (95% confidence interval [CI], 1.01–15.90). Of the surgery group, 18 received neoadjuvant chemotherapy. Pathological prognostic factors and optimal adjuvant therapies were evaluated for the 70 patients. Forty-one patients received adjuvant chemotherapy with etoposide–platinum (EP) or irinotecan–platinum (CPT–P). Multivariate analyses identified the invasion of lymphovascular spaces as a significant prognostic factor for both OS and DFS. Pelvic lymph node metastasis was also a prognostic factor for DFS. Adjuvant chemotherapy with an EP or CPT–P regimen appeared to improve DFS (HR = 0.27, 95% CI, 0.10–0.69). A trend toward improved OS was also observed, but was not statistically significant (HR = 0.39, 95% CI, 0.15–1.01). Conclusion Radical surgery followed by adjuvant chemotherapy with an EP or CPT–P regimen was optimal treatment for stages I and II HGNEC of the uterine cervix.

AB - Purpose We aimed to determine appropriate treatment guidelines for patients with stages I–II high-grade neuroendocrine carcinomas (HGNEC) of the uterine cervix in a multicenter retrospective study. Patients and methods We reviewed the clinicopathological features and prognoses of 93 patients with HGNEC of International Federation of Gynecology and Obstetrics (FIGO) stages I and II. All patients were diagnosed with HGNEC by central pathological review. Results The median overall survival (OS) and disease-free survival (DFS) were 111.3 months and 47.4 months, respectively. Eighty-eight patients underwent radical surgery, and five had definitive radiotherapy. The hazard ratio (HR) for death after definitive radiotherapy to death after radical surgery was 4.74 (95% confidence interval [CI], 1.01–15.90). Of the surgery group, 18 received neoadjuvant chemotherapy. Pathological prognostic factors and optimal adjuvant therapies were evaluated for the 70 patients. Forty-one patients received adjuvant chemotherapy with etoposide–platinum (EP) or irinotecan–platinum (CPT–P). Multivariate analyses identified the invasion of lymphovascular spaces as a significant prognostic factor for both OS and DFS. Pelvic lymph node metastasis was also a prognostic factor for DFS. Adjuvant chemotherapy with an EP or CPT–P regimen appeared to improve DFS (HR = 0.27, 95% CI, 0.10–0.69). A trend toward improved OS was also observed, but was not statistically significant (HR = 0.39, 95% CI, 0.15–1.01). Conclusion Radical surgery followed by adjuvant chemotherapy with an EP or CPT–P regimen was optimal treatment for stages I and II HGNEC of the uterine cervix.

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