目的:本研究的目的是回顾小细胞神经内分泌宫颈癌(SCNEC)的临床病理特征并确定最佳治疗方法。
方法:日本妇科肿瘤学会在2004年至2015年间对日本妇产科学会妇科肿瘤登记处的SCNEC进行了一项回顾性队列研究。所有病例均由国际妇产科联合会(2008年国际癌症控制联盟第7版)修改并统一。
结果:从2004年到2015年,有822名注册患者诊断为SCNEC,占所有宫颈癌病例的1.1%(822/73,698)。T1b2的淋巴结转移和远处转移率明显高于T1b2(38.9%和13.7%,分别)高于T1b1(14.2%和4.4%,分别)(p<0.01)。在IB2和T1bN1M0SCNEC中,手术后化疗的5年生存率明显高于手术后放疗/同步放化疗的5年生存率(p<0.01)。
结论:SNCEC大小>4cm的肿瘤与≤4cm的肿瘤相比,淋巴结和远处转移率更高。辅助化疗,而不是放射治疗,T1bN1M0SCNEC可改善术后预后。
The aim of this study was to review the clinicopathological characteristics of small cell neuroendocrine cervical cancer (SCNEC) and to identify the optimal treatment.
The Japanese Society of Gynecologic Oncology conducted a retrospective cohort study of SCNECs enrolled in the Gynecological Tumor Registry of the Japan Society of Obstetrics and Gynecology between 2004 and 2015. All cases were modified and unified by International Federation of Gynecology and Obstetrics 2008 (Union for International Cancer Control 7th edition).
There were 822 registered patients diagnosed with SCNEC from 2004 to 2015 which comprised 1.1% (822/73,698) of all uterine cervical cancer cases. Rates of lymph-node and distant metastasis were significantly higher in T1b2 (38.9% and 13.7%, respectively) than T1b1 (14.2% and 4.4%, respectively) (p<0.01). In IB2 and T1bN1M0 SCNEC, the 5-year survival rate with surgery followed by chemotherapy was significantly higher than that with surgery followed by radiation therapy/concurrent chemoradiation therapy (p<0.01).
SNCEC tumors >4 cm in size had greater rates of lymph-node and distant metastasis when compared with tumors ≤4 cm. Adjuvant chemotherapy, rather than radiotherapy, may improve prognosis after surgery in T1bN1M0 SCNEC.