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Annals of Oncology Advance Access originally published online on October 24, 2007
Annals of Oncology 2008 19(2):321-326; doi:10.1093/annonc/mdm465
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© 2007 European Society for Medical Oncology. For Permissions, please email: journals.permissions@oxfordjournals.org

gynecologic tumors

Prognostic factors in FIGO stage IB–IIA small cell neuroendocrine carcinoma of the uterine cervix treated surgically: results of a multi-center retrospective Korean study

J.-M. Lee1, K.-B. Lee2, J.-H. Nam3, S.-Y. Ryu4, D.-S. Bae5, J.-T. Park6, S.-C. Kim7, S.-D. Cha8, K.-R. Kim9, S.-Y. Song10 and S.-B. Kang11,*

1 Department of Obstetrics and Gynecology, East-West Neo Medical Center, Kyung Hee University, Seoul
2 Department of Obstetrics and Gynecology, Gachon University, Gil Medical Center, Inchon
3 Department of Obstetrics and Gynecology, University of Ulsan, Asan Medical Center, Seoul
4 Department of Obstetrics and Gynecology, Korea Cancer Center Hospital, Seoul
5 Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
6 Department of Obstetrics and Gynecology, Pochun CHA University CHA Hospital, Seoul
7 Department of Obstetrics and Gynecology, Ewha womans University Mokdong hospital, Seoul
8 Department of Obstetrics and Gynecology, Keimyung University Dongsan Medical Center, Daegu
9 Department of Pathology, University of Ulsan, Asan Medical Center, Seoul
10 Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul
11 Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, Korea

* Correspondence to: Prof. S.-B. Kang, Department of Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul 110-744, Korea. Tel: +82-2-2072-3384; Fax: +82-2-742-2028; E-mail: ksboo308{at}plaza.snu.ac.kr

Background: To determine the clinical and pathologic prognostic factors in surgically treated patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB–IIA small cell neuroendocrine carcinoma of the uterine cervix (SCNEC).

Patients and methods: We retrospectively reviewed a total of 68 patients with FIGO stage IB–IIA SCNEC surgically treated from January 1997 to December 2003 in Korea.

Results: Of the 68 patients, 43 had FIGO stage IB1 SCNEC, 15 had stage IB2, and 10 had stage IIA. Seven were treated with radical surgery alone; 11 with neoadjuvant chemotherapy (NACT) followed by radical surgery; 24 with radical surgery followed by adjuvant chemotherapy; and 26 with radical surgery followed by adjuvant radiation or chemoradiation. After a median follow-up of 44 months (range, 6–113 months), the 2-year and 5-year survival rates for all patients were 64.6% and 46.6%, respectively. Univariate and multivariate analysis showed that FIGO stage was predictive of poor prognosis. Patients who received NACT showed poorer prognosis than those who did not receive NACT. Adjuvant chemoradiation did not improve survival compared with adjuvant chemotherapy alone.

Conclusions: FIGO stage may act as a surrogate for factors prognostic of survival. Primary radical surgery followed by adjuvant chemotherapy is the preferred treatment modality for patients with early stage SCNEC.

Key words: neuroendocrine carcinoma, prognosis, small cell, uterine cervix

Received for publication March 17, 2007. Revision received August 28, 2007. Accepted for publication August 29, 2007.


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