TY - JOUR
T1 - A multi-center retrospective study of neuroendocrine tumors of the uterine cervix
T2 - Prognosis according to the new 2018 staging system, comparing outcomes for different chemotherapeutic regimens and histopathological subtypes
AU - Ishikawa, Mitsuya
AU - Kasamatsu, Takahiro
AU - Tsuda, Hitoshi
AU - Fukunaga, Masaharu
AU - Sakamoto, Atsuhiko
AU - Kaku, Tsunehisa
AU - Kato, Tatsuya
AU - Takahashi, Kazuaki
AU - Ariyoshi, Kazuya
AU - Suzuki, Kayo
AU - Arimoto, Takahide
AU - Matsumoto, Yoshinari
AU - Nakai, Hidekatsu
AU - Inoue, Takafumi
AU - Yokoyama, Masatoshi
AU - Kawabata, Takayo
AU - Kodama, Shoji
AU - Miyamoto, Tsutomu
AU - Takano, Masashi
AU - Yaegashi, Nobuo
N1 - Funding Information:
This work was supported in part by the National Cancer Center Research and Development Fund of Japan (23-A-17, 26-A-4, and 29-A-3) and by the Japan Agency for Medical Research and Development (AMED, JP17ck0106222, JP18ck0106222 and JP19ck0106513).The National Cancer Center Research and Development Fund (23-A-17, 26-A-4, and 29-A-3) was involved in the collection and analysis of data, the CPR, the writing of the report, and in the decision to submit the article for publication. The Japan Agency for Medical Research and Development (AMED), JP17ck0106222, JP18ck0106222 and JP19ck0106513 was involved in the writing of the report and the decision to submit the article for publication.This work was supported in part by the National Cancer Center Research and Development Fund of Japan (23-A-17, 26-A-4, and 29-A-3) and by the Japan Agency for Medical Research and Development (AMED, JP17ck0106222, JP18ck0106222 and JP19ck0106513). The following JCOG–GCSG institutions participated in this study: Hokkaido University (Dr. Tatsuya Kato); University of Tsukuba (Dr. Satoshi Okada); National Defense Medical College (Dr. Masashi Takano); Saitama Cancer Center (Dr. Yoko Hasumi); The Jikei University Kashiwa Hospital (Dr. Kayo Suzuki); National Cancer Center Hospital (Mitsuya Ishikawa); Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital (Dr. Yoshimi Taniguchi); Keio University (Dr. Takashi Iwata); The Jikei University (Dr. Kazuaki Takahashi); The University of Tokyo (Dr. Takahide Arimoto); Juntendo University (Dr. Hiroshi Kaneda); Kitasato University (Dr. Shigemitsu Ono); Niigata Cancer Center Hospital (Dr. Shoji Kodama); Shinshu University (Dr. Tsutomu Miyamoto); Aichi Cancer Center Hospital (Dr. Toru Nakanishi); Nagoya University (Dr. Mika Mizuno); Kyoto University (Dr. Tsukasa Baba); Osaka City University (Dr. Yoshinari Matsumoto); Kindai University (Dr. Hidekatsu Nakai); National Hospital Organization, Shikoku Cancer Center (Dr. Takayoshi Nogawa); National Hospital Organization, Kyushu Cancer Center (Dr. Kazuya Ariyoshi); Kyushu University (Dr. Takafumi Inoue); Saga University (Dr. Masatoshi Yokoyama and Dr. Satomi Aihara); Kumamoto University (Dr. Fumitaka Saito); Kagoshima City Hospital (Dr. Takayo Kawabata); and University of the Ryukyus (Dr. Wataru Kudaka). We would also like to gratefully acknowledge the enormous contributions of Dr. Masayuki Yoshida (National Cancer Center Hospital, Tokyo, Japan) to the CPR, and Dr. Aya Kuchiba (National Cancer Center Hospital, Tokyo, Japan) to statistical analysis.
Funding Information:
This work was supported in part by the National Cancer Center Research and Development Fund of Japan ( 23-A-17 , 26-A-4 , and 29-A-3 ) and by the Japan Agency for Medical Research and Development ( AMED , JP17ck0106222 , JP18ck0106222 and JP19ck0106513 ).
Publisher Copyright:
© 2019 Elsevier Inc.
PY - 2019/12
Y1 - 2019/12
N2 - Objective: To analyze the clinical behavior of neuroendocrine tumors (NETs) of the uterine cervix, we conducted a multicenter, retrospective study of 193 patients. Methods: We evaluated the prognosis of NETs according to the new International Federation of Gynecology and Obstetrics (FIGO) staging system, compared the clinical response to different chemotherapy regimens, and compared different histological subtypes of NETS. Results: Diagnoses of the subjects were atypical carcinoid tumor (ACT, n = 37), small cell neuroendocrine carcinoma (SCNEC, n = 126), large cell neuroendocrine carcinoma (LCNEC, n = 22), and NET, not elsewhere classified (n = 8), according to central pathological review. According to FIGO 2018, 69, 17, 74, and 33 patients were at stage I, II, III, or IV, respectively. Five-year survival was 64.5%, 50.1%, 30.2%, and 3.4% for patients at stage I, II, III and IV. About 40% of patients with stage IIIC1 survived >5 years. On multivariate analyses, locally-advanced disease, para-aortic node metastasis, distant metastasis, and <4 cycles of chemotherapy were associated with poor survival. Histological subtype and pelvic node metastasis had no prognostic significance. Response rates to etoposide-platinum (EP) or irinotecan-platinum (CPT-P) regimens were 43.8% (28/64), but only 12.9% to a taxane-platinum (TC) regimen (4/31). The response rate for ACT was 8.7% (2/23), significantly less than the 36.6% for high-grade neuroendocrine carcinomas (HGNEC: both SCNEC and LCNEC, 41/111). Conclusions: Locally-advanced, extra-pelvic disease and insufficient chemotherapy were independent prognostic factors for cervical NET. HGNEC showed good responses to EP or CPT-P but not TC. Chemotherapy was less effective for ACT, which had a prognosis identical to HGNEC.
AB - Objective: To analyze the clinical behavior of neuroendocrine tumors (NETs) of the uterine cervix, we conducted a multicenter, retrospective study of 193 patients. Methods: We evaluated the prognosis of NETs according to the new International Federation of Gynecology and Obstetrics (FIGO) staging system, compared the clinical response to different chemotherapy regimens, and compared different histological subtypes of NETS. Results: Diagnoses of the subjects were atypical carcinoid tumor (ACT, n = 37), small cell neuroendocrine carcinoma (SCNEC, n = 126), large cell neuroendocrine carcinoma (LCNEC, n = 22), and NET, not elsewhere classified (n = 8), according to central pathological review. According to FIGO 2018, 69, 17, 74, and 33 patients were at stage I, II, III, or IV, respectively. Five-year survival was 64.5%, 50.1%, 30.2%, and 3.4% for patients at stage I, II, III and IV. About 40% of patients with stage IIIC1 survived >5 years. On multivariate analyses, locally-advanced disease, para-aortic node metastasis, distant metastasis, and <4 cycles of chemotherapy were associated with poor survival. Histological subtype and pelvic node metastasis had no prognostic significance. Response rates to etoposide-platinum (EP) or irinotecan-platinum (CPT-P) regimens were 43.8% (28/64), but only 12.9% to a taxane-platinum (TC) regimen (4/31). The response rate for ACT was 8.7% (2/23), significantly less than the 36.6% for high-grade neuroendocrine carcinomas (HGNEC: both SCNEC and LCNEC, 41/111). Conclusions: Locally-advanced, extra-pelvic disease and insufficient chemotherapy were independent prognostic factors for cervical NET. HGNEC showed good responses to EP or CPT-P but not TC. Chemotherapy was less effective for ACT, which had a prognosis identical to HGNEC.
KW - Cervical carcinoma
KW - Chemotherapy
KW - Neuroendocrine tumor
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U2 - 10.1016/j.ygyno.2019.09.018
DO - 10.1016/j.ygyno.2019.09.018
M3 - Article
C2 - 31635755
AN - SCOPUS:85073741201
VL - 155
SP - 444
EP - 451
JO - Gynecologic Oncology
JF - Gynecologic Oncology
SN - 0090-8258
IS - 3
ER -