Yuanyuan Zhang1, Yi Huang2, Suiyu Luo3, Lin Li4, Hongying Yang5, Ziyi Wang6, Yongmei Peng5, Manni Huang1, Jusheng An1, Xi Yang1, Jing Wang6, Chunmei Li3, Lingying Wu1. 1. Department of Gynecologic Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College, Beijing, PR China. 2. Department of Gynecologic Oncology, Hubei Province Cancer Center/Hubei Cancer Hospital, The Affiliated Cancer Hospital of Tongji Medical Colleague of Huazhong University of Science and Technology, Wuhan, PR China. 3. Department of Gynecology and Obstetrics, Henan Provincial People's Hospital/Zhengzhou University People's Hospital, The Affiliated People's Hospital of Henan University, Zhengzhou, PR China. 4. Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, Chongqing, PR China. 5. Department of Gynecologic Oncology, Yunnan Province Cancer Center/Yunnan Cancer Hospital, The Third Affiliated Hospital of Kunming Medical University, Kunming, PR China. 6. Department of Gynecologic Oncology, Hunan Cancer Hospital, The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, PR China.
Abstract
OBJECTIVE: To explore the management of high-grade neuroendocrine cervical cancer (HGNECC) since there has been no standard treatment for it. METHODS: Data on the management of HGNECC were retrospectively analyzed. Patients with FIGO stage IIB to IVB HGNECC from six hospitals were enrolled. The Kaplan-Meier method was used for survival analysis. Prognostic factors were determined using a Cox proportional-hazards regression model. RESULTS: A total of 43 patients were included in the study. The multivariate analysis showed that chemotherapy was the preferred treatment as it improved progression-free survival (PFS; P = 0.008) and overall survival (OS; P = 0.005). Distance metastasis was a significant negative prognostic factor for OS (P = 0.002), while radical surgery was a significant positive prognostic factor for PFS (P = 0.05). Compared with those who had received cisplatin and etoposide (≥5 cycles), patients who had received paclitaxel plus platinum-based chemotherapy showed better PFS and OS. Five patients (two at stage IIB and three at stage IV) showed relatively long-term survival. Of these patients, four had undergone radical surgery including tumor-debulking, while three also received adjuvant chemotherapy. CONCLUSION: Paclitaxel plus cisplatin or paclitaxel plus carboplatin may be more effective than etoposide plus cisplatin. Radical surgery followed by chemotherapy may be a favorable alternative intervention for selected patients with advanced stage cancer.
OBJECTIVE: To explore the management of high-grade neuroendocrine cervical cancer (HGNECC) since there has been no standard treatment for it. METHODS: Data on the management of HGNECC were retrospectively analyzed. Patients with FIGO stage IIB to IVB HGNECC from six hospitals were enrolled. The Kaplan-Meier method was used for survival analysis. Prognostic factors were determined using a Cox proportional-hazards regression model. RESULTS: A total of 43 patients were included in the study. The multivariate analysis showed that chemotherapy was the preferred treatment as it improved progression-free survival (PFS; P = 0.008) and overall survival (OS; P = 0.005). Distance metastasis was a significant negative prognostic factor for OS (P = 0.002), while radical surgery was a significant positive prognostic factor for PFS (P = 0.05). Compared with those who had received cisplatin and etoposide (≥5 cycles), patients who had received paclitaxel plus platinum-based chemotherapy showed better PFS and OS. Five patients (two at stage IIB and three at stage IV) showed relatively long-term survival. Of these patients, four had undergone radical surgery including tumor-debulking, while three also received adjuvant chemotherapy. CONCLUSION: Paclitaxel plus cisplatin or paclitaxel plus carboplatin may be more effective than etoposide plus cisplatin. Radical surgery followed by chemotherapy may be a favorable alternative intervention for selected patients with advanced stage cancer.
Authors: M Frumovitz; M F Munsell; J K Burzawa; L A Byers; P Ramalingam; J Brown; R L Coleman Journal: Gynecol Oncol Date: 2016-11-04 Impact factor: 5.482