101
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Cho WK, Park W, Kim YS, Kang HC, Kim JH, Kim KS, Choi KH, Chang SK, Ahn KJ, Lee SH, Kim S, Kim J, Eom KY, Lee J, Lee JH, Choi JH. Optimal treatment strategies for small cell carcinoma of the uterine cervix: A retrospective multi-center study (KROG 19-03). Eur J Obstet Gynecol Reprod Biol 2021; 258:396-400. [PMID: 33545454 DOI: 10.1016/j.ejogrb.2021.01.034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 01/04/2021] [Accepted: 01/19/2021] [Indexed: 10/22/2022]
Abstract
OBJECTIVE This multi-institutional study aimed to identify the optimal treatment strategy for small cell carcinoma of the cervix. STUDY DESIGN We retrospectively collected the medical records of 166 patients diagnosed with small cell carcinoma of the uterine cervix from January 2000 to December 2015 from 13 institutions of the Korean Radiation Oncology Group. After excluding 18 (10.8 %) patients who initially had distant metastasis, the treatment outcomes of 148 patients were analyzed. RESULTS After a median 46.4 (1.4-231.9) months of follow-up, the 5-year progression-free survival (PFS) and overall survival (OS) rates of all patients were 45.9 % and 63.5 %, respectively. Distant metastasis was the dominant pattern of failure occurring in 67 patients (45.3 %). We stratified the patients according to the primary local treatment: primary surgery (n = 119), primary radiotherapy (RT) (n = 26), and no local treatment group (n = 3). Although the primary RT group had advanced disease (FIGO stage ≧ IIB) more frequently than the primary surgery group (80.8 % vs. 47.9 %), the PFS and OS did not differ between the groups in multivariate analysis. CONCLUSION Definitive RT is a reasonable local treatment option for small cell cervical cancer, particularly for advanced cases. Given the high rates of distant relapse, an effective systemic therapy protocol is warranted for small cell cervical cancer patients.
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Affiliation(s)
- Won Kyung Cho
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Won Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
| | - Young Seok Kim
- Department of Radiation Oncology, Asan Medical Center, Ulsan University School of Medicine, Seoul, Republic of Korea.
| | - Hyun-Cheol Kang
- Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Jin Hee Kim
- Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Kyung Su Kim
- Department of Radiation Oncology, Ewha Womans University School of Medicine, Seoul, Republic of Korea
| | - Kyu Hye Choi
- Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sei Kyung Chang
- Department of Radiation Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea
| | - Ki Jung Ahn
- Department of Radiation Oncology, Inje University Busan Paik Hospital, Busan, Republic of Korea
| | - Seok Ho Lee
- Department of Radiation Oncology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea
| | - Sunghyun Kim
- Department of Radiation Oncology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Republic of Korea
| | - Juree Kim
- Department of Radiation Oncology, CHA Medical Center, Cha University, Goyang, Republic of Korea
| | - Keun-Yong Eom
- Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoungnam, Republic of Korea
| | - Jeongshim Lee
- Department of Radiation Oncology, Inha University Hospital, Incheon, Republic of Korea
| | - Jong Hoon Lee
- Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Jin Hwa Choi
- Department of Radiation Oncology, Chung-Ang University Hospital, Seoul, Republic of Korea
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102
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Hasanzadeh M, Babapour N, Farazestanian M, Hashem Niay Torshizi F. Small Cell Neuroendocrine Cervical Carcinoma: A Case Report. J Family Reprod Health 2021; 14:273-275. [PMID: 34055000 PMCID: PMC8144480 DOI: 10.18502/jfrh.v14i4.5212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Objective: Small cell neuroendocrine cervical carcinoma is a neuroendocrine tumor with the great aggravation that comprises 0.5 to 3 percent of cervical tumors and progresses rapidly with early lymphogenous and hematogenous metastases. Case report: We reported a 40 years old woman with cervical cancer in stage IB2 that had radical hysterectomy with mistaken diagnosis of squamous cervical cancer. The disease has progressed after 50 days of surgery with a 6 cm tumor in vaginal cuff; review of pathology demonstrated small cell neuroendocrine cervical carcinoma. Conclusion: Recognition of this separate histopathological entity with IHC analysis is important. Chemoradiotherapy and multimodality therapeutic approaches could improve the survival rates.
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Affiliation(s)
- Malihe Hasanzadeh
- Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Nooshin Babapour
- Department of Obstetrics and Gynecology, Faculty of Medicine, Azad Islamic University, Mashhad, Iran
| | - Marjaneh Farazestanian
- Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Farzaneh Hashem Niay Torshizi
- Department of Obstetrics and Gynecology, Women's Health Research Center, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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103
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Opalińska M, Sowa-Staszczak A, Olearska H, Ulatowska-Bialas M, Gilis-Januszewska A, Hubalewska-Dydejczyk A. Clinical Approach to Neuroendocrine Neoplasm Associated With Ovarian Teratoma. Front Endocrinol (Lausanne) 2021; 12:770266. [PMID: 34917031 PMCID: PMC8670552 DOI: 10.3389/fendo.2021.770266] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Accepted: 11/03/2021] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Neuroendocrine neoplasms are a heterogeneous group of cancers that develop from enterochromaffin cells of the diffuse endocrine system, with an increase in incidents over the last years. Ovarian neuroendocrine tumors (NET) are rare neoplasms, comprising 0.1% of all ovarian neoplasms and less than 5% of all neuroendocrine tumors. They may arise alone (as monodermal, specialized teratoma - ovarian carcinoid) or as a part of other ovarian lesion: cystic mature or immature teratomas. Due to the rarity and limited amount of such cases reported in the literature, there is no consensus on diagnostic and therapeutic procedures in this group of patients. MATERIALS AND METHODS The group of 10 patients at the age of 19 to 77 years (mean 42.8 ± 17.9), diagnosed with unilateral NET within ovarian teratoma were analyzed. The histopathological type of tumor, progression free survival after surgical treatment and presence of hormonally active syndrome were assessed. RESULTS 70% (n=7) of patients was diagnosed with mature cystic teratomas containing NET component and 30% (n=3) with monodermal teratoma (strumal carcinoid). All cases of monodermal teratomas were found in women at premenopausal age. Determined Ki67 ranged from 2% to 9%. Ninety percent of lesions (n=9) stained positive for synaptophysin and chromogranin, while markers: CK20, CK7, TTF-1 and CDX2 were negative in all cases, which ruled out their metastatic nature. None of the patients presented with carcinoid syndrome. All followed-up patients remain progression-free, which confirms surgical intervention being a crucial and sufficient method of treatment. CONCLUSIONS The prognosis and clinical behavior of NETs associated with ovarian teratomas are good with long progression-free survival.
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Affiliation(s)
- Marta Opalińska
- Nuclear Medicine Unit, Department of Endocrinology Department of Endocrinology, Oncological Endocrinology and Nuclear Medicine, University Hospital, Kraków, Poland
| | - Anna Sowa-Staszczak
- Chair and Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland
- *Correspondence: Anna Sowa-Staszczak,
| | - Helena Olearska
- Chair and Department of Endocrinology, Jagiellonian University Medical College, Kraków, Poland
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104
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Bidkar VC, Acharya G, Kulkarni KA, Sumangala G, Premalatha TS, Vamsi P. Neuroendocrine Carcinoma of Female Genital Tract: Series of Nine Cases. INDIAN JOURNAL OF GYNECOLOGIC ONCOLOGY 2021. [DOI: 10.1007/s40944-020-00480-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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105
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Griesinger LM, Szczepanski JM, McMullen ER, Skala SL. Uncommon Cervical Lesions: A Review and Discussion of the Differential Diagnosis. Arch Pathol Lab Med 2020; 145:891-902. [PMID: 33091926 DOI: 10.5858/arpa.2020-0327-ra] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2020] [Indexed: 11/06/2022]
Abstract
CONTEXT.— While the vast majority of cervical tumors consist of human papillomavirus (HPV)-related squamous cell carcinoma or adenocarcinoma, a subset of rare tumor types, frequently unrelated to HPV, does occur in this location. These tumors vary widely in prognostic and therapeutic implications, and accurate recognition is crucial to providing appropriate treatment. Some are benign or portend a favorable prognosis (adenoid basal carcinoma, ectopic prostate tissue), while others are frankly malignant lesions with a less favorable prognosis (adenoid cystic carcinoma, HPV-negative endocervical adenocarcinoma, mesonephric adenocarcinoma, clear cell carcinoma, small cell carcinoma, and adenosquamous carcinoma). OBJECTIVE.— To review the morphologic features of uncommon cervical lesions, the utility of immunohistochemistry for distinction between these entities, and the clinical and prognostic implications of accurate diagnosis. DATA SOURCES.— University of Michigan cases and review of the pertinent literature regarding the entities described. CONCLUSIONS.— Key morphologic and immunohistochemical features detailed herein will allow for the accurate distinction between these uncommon cervical lesions. Morphology is most useful in discriminating between the entities, as there is frequent immunohistochemical overlap between them; however, in rare instances immunohistochemistry can be useful in resolving the diagnosis.
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Affiliation(s)
- Laurie M Griesinger
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor
| | | | - Emily R McMullen
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor
| | - Stephanie L Skala
- From the Department of Pathology, University of Michigan Medical School, Ann Arbor
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106
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Yu L, Suye S, Huang R, Liang Q, Fu C. Expression and clinical significance of a new neuroendocrine marker secretagogin in cervical neuroendocrine carcinoma. J Clin Pathol 2020; 74:787-795. [PMID: 33060116 DOI: 10.1136/jclinpath-2020-206889] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/08/2020] [Accepted: 09/17/2020] [Indexed: 12/11/2022]
Abstract
AIMS To explore the expression of secretagogin (SCGN) in neuroendocrine carcinoma of the uterine cervix and analyse its relationship with clinicopathological characteristics and prognosis. METHODS From January 2010 to December 2017, 44 patients with cervical neuroendocrine carcinoma undergoing surgery were included in the study group, and 55 patients with cervical non-neuroendocrine carcinoma (including 30 cases of cervical squamous cell carcinoma and 25 cases of cervical adenocarcinoma) undergoing surgery were included in the control group. Immunohistochemical staining of SCGN was performed in both groups and compared with three common neuroendocrine markers, chromogranin A, synaptophysin (Syn) and CD56 in the study group. Detailed clinicopathological data of the two groups were analysed, and the patient survival in the study group was followed up. RESULTS The positive expression of SCGN in cervical neuroendocrine carcinoma, cervical adenocarcinoma and squamous cell carcinoma was 65.9% (29/44), 8% (2/25) and 0%, respectively. The positive expression of SCGN in cervical neuroendocrine carcinoma was significantly higher than that in cervical adenocarcinoma and squamous cell carcinoma (χ2=44.5, p<0.001). There were no statistical differences among the positive expression of SCGN and three common neuroendocrine markers (p>0.05 for all). The intensity of SCGN staining in patients with cervical neuroendocrine carcinoma with lymph node metastasis was significantly higher than that in patients without lymph node metastasis (p=0.020). However, there was no significant association between SCGN expression and survival among patients with cervical neuroendocrine carcinoma (p=0.633). CONCLUSIONS SCGN is a new neuroendocrine marker for cervical neuroendocrine carcinoma, whose expression correlates with lymph node metastasis.
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Affiliation(s)
- Li Yu
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China.,Department of Gynecology, Yiyang Central Hospital, Yiyang, Hunan, China
| | - Suye Suye
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Rui Huang
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Qinchun Liang
- Department of Pathology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
| | - Chun Fu
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, Hunan, China
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107
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Eskander RN, Elvin J, Gay L, Ross JS, Miller VA, Kurzrock R. Unique Genomic Landscape of High-Grade Neuroendocrine Cervical Carcinoma: Implications for Rethinking Current Treatment Paradigms. JCO Precis Oncol 2020; 4:1900248. [PMID: 33015532 PMCID: PMC7529537 DOI: 10.1200/po.19.00248] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2020] [Indexed: 12/18/2022] Open
Abstract
PURPOSE High-grade neuroendocrine cervical cancer (HGNECC) is an uncommon malignancy with limited therapeutic options; treatment is patterned after the histologically similar small-cell lung cancer (SCLC). To better understand HGNECC biology, we report its genomic landscape. PATIENTS AND METHODS Ninety-seven patients with HGNECC underwent comprehensive genomic profiling (182-315 genes). These results were subsequently compared with a cohort of 1,800 SCLCs. RESULTS The median age of patients with HGNECC was 40.5 years; 83 patients (85.6%) harbored high-risk human papillomavirus (HPV). Overall, 294 genomic alterations (GAs) were identified (median, 2 GAs/sample; average, 3.0 GAs/sample, range, 0-25 GAs/sample) in 109 distinct genes. The most frequently altered genes were PIK3CA (19.6% of cohort), MYC (15.5%), TP53 (15.5%), and PTEN (14.4%). RB1 GAs occurred in 4% versus 32% of HPV-positive versus HPV-negative tumors (P < .0001). GAs in HGNECC involved the following pathways: PI3K/AKT/mTOR (41.2%); RAS/MEK (11.3%); homologous recombination (9.3%); and ERBB (7.2%). Two tumors (2.1%) had high tumor mutational burden (TMB; both with MSH2 alterations); 16 (16.5%) had intermediate TMB. Seventy-one patients (73%) had ≥ 1 alteration that was theoretically druggable. Comparing HGNECC with SCLC, significant differences in TMB, microsatellite instability, HPV-positive status, and in PIK3CA, MYC, PTEN, TP53, ARID1A, and RB1 alteration rates were found. CONCLUSION This large cohort of patients with HGNECC demonstrated a genomic landscape distinct from SCLC, calling into question the biologic and therapeutic relevance of the histologic similarities between the entities. Furthermore, 73% of HGNECC tumors had potentially actionable alterations, suggesting novel treatment strategies for this aggressive malignancy.
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Affiliation(s)
- Ramez N Eskander
- Department of Obstetrics, Gynecology and Reproductive Sciences, Division of Gynecologic Oncology, University of California San Diego, La Jolla, CA.,Center for Personalized Cancer Therapy, University of California San Diego, La Jolla, CA
| | | | | | - Jeffrey S Ross
- Foundation Medicine, Cambridge, MA.,Upstate Medical University, Syracuse, NY
| | | | - Razelle Kurzrock
- Center for Personalized Cancer Therapy, University of California San Diego, La Jolla, CA.,Department of Medicine, Division of Hematology/Oncology, University of California San Diego, La Jolla, CA
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108
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Mori Y, Kida Y, Matsushita Y, Mizumatsu S, Hatano M, Morita N, Tsuzuki T. Neuroendocrine Carcinoma of Uterine Cervix: Stereotactic Radiotherapy for Brain Metastasis and Stereotactic Body Radiotherapy for Renal and Pancreatic Metastases. Cureus 2020; 12:e8869. [PMID: 32754406 PMCID: PMC7386082 DOI: 10.7759/cureus.8869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A case of cervical neuroendocrine carcinoma (NEC) of the uterine cervix (NECUC) was presented. After total hysterectomy with bilateral salpingo-oophorectomy and adjuvant chemotherapy, a left renal tumor and a pancreatic lesion developed and were both diagnosed on pathological examination as metastases from NEC. In addition, a brainstem metastasis causing neurologic signs developed. The brain lesion was treated by stereotactic radiotherapy (SRT) and the renal and pancreatic lesions by stereotactic body radiotherapy (SBRT). Despite control of the renal and pancreatic lesions, multiple small lung metastases developed later. Recurrence and newly developed brain metastases were treated by repeat stereotactic radiosurgery (SRS)/SRT successfully. Chemotherapy was continued and controlled the lung metastases until three and a half years after the initial operation of the uterus.
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Affiliation(s)
- Yoshimasa Mori
- Radiation Oncology and Neurological Surgery, Shin-Yurigaoka General Hospital, Kawasaki, JPN.,Radiology and Radiation Oncology, Aichi Medical University, Nagakute, JPN.,Neurological Surgery, Ookuma Hospital, Nagoya, JPN.,Neurological Surgery, Aoyama General Hospital, Toyokawa, JPN
| | | | | | | | - Manabu Hatano
- Neurological Surgery, Radiosurgery, CyberKnife Center, Aoyama General Hospital, Toyokawa, JPN
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109
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Huang R, Gan Q, Cheng J. Prognostic Factors and Local Treatment Modalities of Small-Cell Carcinoma of the Cervix: An Analysis According to the International Federation of Gynecology and Obstetrics Stage. Cancer Manag Res 2020; 12:3445-3456. [PMID: 32523375 PMCID: PMC7236046 DOI: 10.2147/cmar.s247081] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2020] [Accepted: 04/23/2020] [Indexed: 12/17/2022] Open
Abstract
Purpose Small-cell carcinoma of the cervix (SCCC) is a rare type of cervical cancer. This study aimed to investigate the clinicopathological characteristics and survival as well as the optimal local treatment modalities for SCCC. Patients and Methods We retrospectively evaluated the data of patients diagnosed with SCCC between 1988 and 2015 in our institution - those included in the Surveillance, Epidemiology, and End Results (SEER) database and those in the Periodical Database. Kaplan-Meier method and Cox regression proportional hazard methods were used to evaluate overall survival (OS). A nomogram that could predict OS was constructed based on the Cox proportional hazard model. Results In total, 695 patients were included in this study. The 5-year overall survival in FIGO stage I-IIA and IIB-IV patients was 45.7% and 14.4%, respectively (P <0.01). Univariate and multivariate analyses showed that lymph node status (P <0.01) and cancer-directed surgery (P <0.01) were independent prognostic factors for FIGO I-IIA stage patients, and age (P <0.05), tumor size (P <0.01), chemotherapy (P <0.01) and radiation (P <0.01) were independent prognostic factors for FIGO stage IIB-IV patients. Conclusion Better prognosis was associated with negative lymph node status, no lymphatic vasculature, surgery, and early-stage patients. Furthermore, our data showed that the prognosis and treatment pattern varied depending on the FIGO stage, and that optimal treatment modalities included radical surgery for early-stage SCCC and chemoradiotherapy for advanced-stage SCCC. It is helpful to assess the individual prognosis of SCCC patients and choose personalized treatment modalities.
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Affiliation(s)
- Ru Huang
- Department of Obstetrics and Gynecology, The Shanghai East Hospital, Shanghai 200120, People's Republic of China
| | - Qiyu Gan
- Department of Obstetrics and Gynecology, The Shanghai East Hospital, Shanghai 200120, People's Republic of China
| | - Jingxin Cheng
- Department of Obstetrics and Gynecology, The Shanghai East Hospital, Shanghai 200120, People's Republic of China
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110
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Zeng F, Tuo Y, Liu D, He M. Rare case of tonsillar and subcutaneous metastasis from neuroendocrine cervical cancer. J Obstet Gynaecol Res 2020; 46:950-954. [PMID: 32266759 DOI: 10.1111/jog.14237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 02/04/2020] [Accepted: 02/24/2020] [Indexed: 11/28/2022]
Abstract
Neuroendocrine cervical carcinoma (NECC) is a rare type of cervical cancer, with high tendency of lymphatic and distant metastasis and poor prognosis. Herein, we reported a rare case of relapsed NECC metastasizing to palatine tonsil and subcutaneous adipose tissue in multiple regions, which reflects the aggressive biological behavior of NECC.
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Affiliation(s)
- Feitianzhi Zeng
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Ying Tuo
- Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Dawei Liu
- Department of Pathology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
| | - Mian He
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China
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111
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Insulinoma-associated protein 1 (INSM1): a potential biomarker and therapeutic target for neuroendocrine tumors. Cell Oncol (Dordr) 2020; 43:367-376. [PMID: 32219703 DOI: 10.1007/s13402-020-00505-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/16/2020] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Insulinoma-associated protein 1 (INSM1), a transcriptional regulator with a zinc-finger DNA-binding domain, has been validated as a cytoplasmic marker for neuroendocrine differentiation of tumor cells. Next to its abundant expression in the fetal pancreas, it is expressed in brain tumors, pheochromocytomas, medullary thyroid carcinomas, insulinomas and pituitary and small-cell lung carcinomas. INSM1 is not expressed in normal adult tissues and/or most non-neuroendocrine tumors. It regulates various downstream signaling pathways, including the Sonic Hedgehog, PI3K/AKT, MEK/ERK1/2, ADK, p53, Wnt, histone acetylation, LSD1, cyclin D1, Ascl1 and N-Myc pathways. Although INSM1 appears to be a subtle and specific biomarker for neuroendocrine tumors, its role in tumor development has remained unclear. CONCLUSIONS Here, we highlight INSMI expression, as well as its diagnostic significance and use as a therapeutic target in various neuroendocrine tumors. Targeting signaling pathways or gene expression alterations associated with INSM1 expression may be instrumental for the design of novel therapeutic strategies for neuroendocrine tumors.
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112
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Guo YT, Lu Y, Jia YY, Qu HN, Qi D, Wang XQ, Song PY, Jin XS, Xu WH, Dong Y, Liang YY, Quan CS. Predictive Value of Pin1 in Cervical Low-Grade Squamous Intraepithelial Lesions and Inhibition of Pin1 Exerts Potent Anticancer Activity against Human Cervical Cancer. Aging Dis 2020; 11:44-59. [PMID: 32010480 PMCID: PMC6961766 DOI: 10.14336/ad.2019.0415] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/15/2019] [Indexed: 12/26/2022] Open
Abstract
Many oncogenes are involved in the progression from low-grade squamous intraepithelial lesions (LSILs) to high-grade squamous intraepithelial lesions (HSILs); which greatly increases the risk of cervical cancer (CC). Thus, a reliable biomarker for risk classification of LSILs is urgently needed. The prolyl isomerase Pin1 is overexpressed in many cancers and contributes significantly to tumour initiation and progression. Therefore, it is important to assess the effects of cancer therapies that target Pin1. In our study, we demonstrated that Pin1 may serve as a biomarker for LSIL disease progression and may constitute a novel therapeutic target for CC. We used a the novel Pin1 inhibitor KPT-6566, which is able to covalently bind to Pin1 and selectively target it for degradation. The results of our investigation revealed that the downregulation of Pin1 by shRNA or KPT-6566 inhibited the growth of human cervical cancer cells (CCCs). We also discovered that the use of KPT-6566 is a novel approach to enhance the therapeutic efficacy of cisplatin (DDP) against CCCs in vitro and in vivo. We showed that KPT-6566-mediated inhibition of Pin1 blocked multiple cancer-driving pathways simultaneously in CCCs. Furthermore, targeted Pin1 treatment suppressed the metastasis and invasion of human CCCs, and downregulation of Pin1 reversed the epithelial-mesenchymal transition (EMT) of CCCs via the c-Jun/slug pathway. Collectively, we showed that Pin1 may be a marker for the risk of progression to HSIL and that inhibition of Pin1 has anticancer effects against CC.
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Affiliation(s)
- Yan-Tong Guo
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Yan Lu
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Yi-Yang Jia
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Hui-Nan Qu
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Da Qi
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Xin-Qi Wang
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Pei-Ye Song
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Xiang-Shu Jin
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Wen-Hong Xu
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Yuan Dong
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Ying-Ying Liang
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
| | - Cheng-Shi Quan
- Key Laboratory of Pathobiology, Ministry of Education, College of Basic Medical Sciences, Jilin University, Changchun, China
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113
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Li J, Ouyang Y, Tao Y, Wang L, Li M, Gao L, Cao X. Small cell carcinoma of the uterine cervix: a multi-institutional experience. Int J Gynecol Cancer 2019; 30:174-180. [PMID: 31792086 DOI: 10.1136/ijgc-2019-000612] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 08/29/2019] [Accepted: 09/03/2019] [Indexed: 11/03/2022] Open
Abstract
OBJECTIVE Small cell carcinoma of the uterine cervix is associated with a poor prognosis with a median overall survival that is quite low. The aim of this study was to determine the clinico-pathologic characteristics that have an impact on survival in patients with small cell carcinoma of the uterine cervix. METHODS A total of 93 patients were involved in this retrospective study. Inclusion criteria were patients diagnosed with histopathologically confirmed small cell carcinoma of the uterine cervix and then later treated at three participating centers, between June 2001 and March 2015. Those without complete available follow-up records were excluded. The endpoints of this study were disease-free survival and overall survival. Kaplan-Meier and Cox regression methods were used for analyses. RESULTS There were statistical differences in overall survival between patients in early and in advanced stages by using the 2009 International Federation of Gynecology and Obstetrics (FIGO) clinical stage. There were 75 patients with FIGO stage I to IIA (56 patients stage I, 17 patients stage IIA, and two patients stage IB or IIA because of uncertainty as to whether the fornix was involved); and 18 patients with FIGO stage IIB and above (10 patients IIB stage, five patients stage III, and three patients stage IV). Among the 76 patients who had surgery, 73 (96%) had a radical hysterectomy with pelvic lymph node dissection and three (4%) patients had a simple hysterectomy without lymph node dissection. For early-stage patients, the 5 year disease-free survival rate was 52.7% compared with 32.4% in the advanced stage group (p=0.022). The disease-free survival for the early-stage group was 64.4% compared with 36.7% in the advanced-stage group (p=0.047). For factors affecting overall survival, age at diagnosis, tumor homology, tumor size, depth of stromal invasion, lymph node involvement, and treatment modality failed to reach significance in both univariate and multivariate analysis. CONCLUSION FIGO stage was a prognostic factor impacting survival-both overall survival and disease-free survival. Age at diagnosis, tumor histology (pure or mixed), tumor size, depth of stromal invasion, lymph node involvement, and treatment modality did not have an impact on overall survival.
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Affiliation(s)
- Junyun Li
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Yi Ouyang
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Yalan Tao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
| | - Ligen Wang
- Cancer Center of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Mingyi Li
- Cancer Center of Guangzhou Medical University, Guangzhou, Guangdong, China
| | - Lei Gao
- Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China
| | - Xinping Cao
- Department of Radiation Oncology, Sun Yat-sen University Cancer Center, Guangzhou, Guangdong, China
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114
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Rais K, Egyir E, Rockson O, Ramdani A, Serji B, El Harroudi T. [Neuroendocrine tumors of the cervix: case study and literature review]. Pan Afr Med J 2019; 34:48. [PMID: 31762914 PMCID: PMC6859045 DOI: 10.11604/pamj.2019.34.48.19861] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2019] [Accepted: 08/18/2019] [Indexed: 11/11/2022] Open
Abstract
Neuroendocrine tumors of the cervix are rare accounting for only 0.9-1.5% of these tumors. The non-specificity of the clinical signs and the absence of a screening test delay diagnosis. Immunohistochemical and histological studies play a crucial role to confirm the diagnosis. Today, therapeutic management is difficult and prognosis is unfavorable. We report a case of neuroendocrine tumor of the cervix and we will outline the peculiarities of this rare disease.
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Affiliation(s)
- Kaoutar Rais
- Service de Chirurgie Oncologique, Centre d'Oncologie Hassan II, Oujda, Maroc
| | - Ebo Egyir
- Service de Chirurgie Oncologique, Centre d'Oncologie Hassan II, Oujda, Maroc
| | - Obeid Rockson
- Service de Chirurgie Oncologique, Centre d'Oncologie Hassan II, Oujda, Maroc
| | - Abdelbassir Ramdani
- Service de Chirurgie Oncologique, Centre d'Oncologie Hassan II, Oujda, Maroc
| | - Badr Serji
- Service de Chirurgie Oncologique, Centre d'Oncologie Hassan II, Oujda, Maroc
| | - Tijani El Harroudi
- Service de Chirurgie Oncologique, Centre d'Oncologie Hassan II, Oujda, Maroc
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115
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Tsuyoshi H, Yashiro K, Yamada S, Yamamoto M, Onuma T, Kurokawa T, Yoshida Y. Role of diagnostic laparoscopy in patients with large cell neuroendocrine carcinoma of the ovary with cancerous peritonitis: case report and review of the literature. J Ovarian Res 2019; 12:95. [PMID: 31615543 PMCID: PMC6792242 DOI: 10.1186/s13048-019-0571-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2019] [Accepted: 09/21/2019] [Indexed: 11/23/2022] Open
Abstract
Background Large cell neuroendocrine carcinoma is a very rare ovarian neoplasm that has a poor clinical outcome even in the early stage, and there is as yet no established treatment. Diagnostic laparoscopy has been used to determine the possibility of primary optimal cytoreductive surgery or neoadjuvant chemotherapy in patients with advanced epithelial ovarian cancer. However, the role of diagnostic laparoscopy is still unclear in large cell neuroendocrine carcinoma due to its rarity. Case presentation A 31-year-old woman with abdominal distention was referred to our hospital. She was strongly suspected of having advanced ovarian cancer because of a huge pelvic mass, massive ascites, and their appearance on medical imaging. However, cytological examinations from ascitic fluid by abdominal paracentesis did not show any malignant cells. She underwent diagnostic laparoscopy to evaluate the possibility of primary optimal cytoreductive surgery, and only tissue sampling was performed for pathological diagnosis because of the countless disseminated lesions of various sizes in the intraperitoneal organs. The patient had no postoperative complications, leading to the early start of postoperative chemotherapy. Conclusions To date, there have been no systematic reviews that focused on determining the treatment strategy using laparoscopy. Diagnostic laparoscopy can be helpful to determine the optimal treatment, including primary debulking surgery, neoadjuvant chemotherapy, or best supportive care, assisting in decision-making particularly for patients with advanced large cell neuroendocrine carcinoma with carcinomatous peritonitis.
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Affiliation(s)
- Hideaki Tsuyoshi
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan.
| | - Kenji Yashiro
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Shizuka Yamada
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Makoto Yamamoto
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Toshimichi Onuma
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Tetsuji Kurokawa
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
| | - Yoshio Yoshida
- Department of Obstetrics and Gynecology, Faculty of Medical Sciences, University of Fukui, 23-3 Shimoaizuki, Matsuoka, Eiheiji-cho, Yoshida-gun, Fukui, 910-1193, Japan
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Sugimoto M, Koyama K, Ichimura T, Shimono T, Hashiguchi Y, Miki Y. Comparison of MR imaging features of uterine neuroendocrine carcinoma and uterine malignant lymphoma. Abdom Radiol (NY) 2019; 44:3377-3387. [PMID: 31473773 DOI: 10.1007/s00261-019-02201-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
PURPOSE We retrospectively investigated the characteristic magnetic resonance (MR) imaging findings of uterine neuroendocrine carcinoma (UNEC) compared to those of uterine malignant lymphoma (UML). METHODS Nine consecutive female patients with UNEC and 5 female patients with UML participated in this study. MR imaging features were evaluated retrospectively. RESULTS On MR imaging, seven of 9 UNEC lesions and no UML lesions showed an exophytic growth pattern. All 9 UNEC lesions and no UML lesions showed a growth pattern along the surface of the endocervix or endometrium. Only 1 UNEC lesion and all 5 UML lesions showed diffuse enlargement of the uterus. No UNEC lesions and all 5 UML lesions showed a multinodular shape. These findings showed significant differences between lesions. Findings for margin, endophytic growth pattern, signal intensity, and homogeneity on T2-weighted and T1-weighted imaging did not differ significantly between lesion types. Apparent diffusion coefficient was significantly lower for UML lesions than for UNEC lesions, but was quite low for both types. Local invasion to surrounding tissues was more frequent in UML lesions than in UNEC lesions. There was no significant difference in the frequency of lymphadenopathy between two entities. CONCLUSIONS UNEC lesions tended to show an exophytic growth pattern and growth along the surface of the endocervix or endometrium, even when diffuse enlargement of the uterus was present, while all UML lesions showed a multinodular shape and diffuse enlargement of the uterus without thickening of the cervical epithelium and endometrium.
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Affiliation(s)
- Michiko Sugimoto
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Osaka, 545-8585, Japan.
| | - Koichi Koyama
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Osaka, 545-8585, Japan
| | - Tomoyuki Ichimura
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Taro Shimono
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Osaka, 545-8585, Japan
| | - Yasunori Hashiguchi
- Department of Obstetrics and Gynecology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Osaka City University Graduate School of Medicine, 1-4-3 Asahi-machi, Abeno-ku, Osaka, Osaka, 545-8585, Japan
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Wharton D, Kim E, Pagan J, Small W, Jaboin J, Ayala-Peacock D. Patterns of Care and Outcomes for Small Cell Carcinoma of the Cervix: A National Retrospective Analysis of 542 Cases. Adv Radiat Oncol 2019; 5:412-418. [PMID: 32529135 PMCID: PMC7276665 DOI: 10.1016/j.adro.2019.08.008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 07/23/2019] [Accepted: 08/26/2019] [Indexed: 11/09/2022] Open
Abstract
Purpose Small cell carcinoma of the cervix (SCCC) represents 1% to 5% of cervical cancers, with limited data on management and outcomes. We evaluated patterns of care and outcomes for SCCC using the National Cancer Database. Methods and Materials This retrospective cohort study of SCCC (2004-2011) included 542 cases. Patient demographic, diagnosis, treatment information, and overall survival (OS) were compared with descriptive statistics, logistic regression, Kaplan-Meier, and Cox models. Clinical reasoning was used to select variables for multivariable models to avoid overfitting. Results SCCC had more comorbidities, higher grade, and advanced stage than other histologies. SCCC received neoadjuvant chemotherapy (36%) more often than squamous cell carcinoma (23%) and adenocarcinoma (13%, P < .001). SCCC had worse OS across all stages (P < .001). Looking at SCCC alone, patients who received chemoradiation (CRT) (with external beam and brachytherapy) and those who received chemotherapy and surgery (without RT) had similar OS (median OS 44 vs 47 months; P = .7) on Kaplan-Meier. Patients receiving CRT were more likely to have stage II or III and N+ disease (P < .001). When evaluating chemoradiation, the addition of brachytherapy resulted in improved median OS (35 vs 19 months; P = .001) regardless of surgical resection status and controlling for age and stage. Even after controlling for stage, age, and comorbidities, the addition of brachytherapy was associated with a 40% improvement in OS (hazard ratio 1.4, 95% confidence interval 1.0-2.0). Conclusions SCCC patients benefit from chemotherapy with aggressive local treatment. Patients who receive CRT that included brachytherapy did as well as patients who received chemotherapy followed by surgery. Brachytherapy remains an essential component in the treatment of SCCC with CRT.
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Affiliation(s)
- David Wharton
- Vanderbilt University School of Medicine, Vanderbilt University, Nashville, Tennessee
| | - Ellen Kim
- Department of Radiation Oncology, Vanderbilt University, Nashville, Tennessee
| | - Jonathan Pagan
- Radiation Oncology Associates Carson City, Carson City, Nevada
| | - William Small
- Department of Radiation Oncology, Loyola University Medical Center, Chicago, Illinois
| | - Jerry Jaboin
- Department of Radiation Medicine, Oregon Health and Science University, Portland, Oregon
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Mei S, Gibbs J, Economos K, Lee YC, Kanis MJ. Clinical comparison between neuroendocrine and endometrioid type carcinoma of the uterine corpus. J Gynecol Oncol 2019; 30:e58. [PMID: 31074241 PMCID: PMC6543113 DOI: 10.3802/jgo.2019.30.e58] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2018] [Revised: 12/28/2018] [Accepted: 01/24/2019] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVE To compare the clinicopathologic features and survival outcomes of neuroendocrine tumor of the uterine corpus (NET-U) to endometrioid type endometrial carcinoma (EC). METHODS From 1993 to 2012, the Surveillance, Epidemiology and End Results cancer registry was queried for women diagnosed with EC or NET-U. Data regarding stage, grade, presence of extra-uterine disease, lymph node metastasis, receipt of adjuvant radiation, surgical intervention and overall survival (OS) was extracted. Chi-square tests, t-tests and Kaplan Meir curves were used for statistical analysis. RESULTS A total of 98,363 patients were identified: 98,245 with EC and 118 with NET-U. The mean age at diagnosis for EC was 61.7 years and 64.8 years for NET-U (p=0.01). NET-U cases were more likely to be poorly differentiated (97.0% vs. 15.6%; p≤0.01) and have nodal metastasis (56.4% vs. 11.1%; p≤0.01) when compared to EC. Presence of extrapelvic disease at the time of diagnosis was observed more frequently in NET-U compared to EC, 49.1% vs. 4.8%, respectively (odds ratio=18; 95% confidence interval=13.1-27.2; p≤0.01). Significant improvement in OS was observed in NET-U patient who received radiation (OS: 7.7 vs. 3.3 years; p≤0.01) or underwent surgical management (5.6 vs. 0.9 years; p≤0.01). The OS for EC was 14.4 vs. 4.6 years for NET-U (p≤0.01). CONCLUSION NET-U represents an aggressive form of uterine malignancy. When compared to EC, patients with NET-U present at more advanced stage, have more frequent extra-uterine disease and lower OS.
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Affiliation(s)
- Shirley Mei
- Division of Gynecologic Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Jennifer Gibbs
- Division of Gynecologic Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA.
| | - Katherine Economos
- Division of Gynecologic Oncology, New York-Presbyterian Brooklyn Methodist Hospital, Brooklyn, NY, USA
| | - Yi Chun Lee
- Division of Gynecologic Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Margaux J Kanis
- Division of Gynecologic Oncology, SUNY Downstate Medical Center, Brooklyn, NY, USA
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Bovbjerg ML. Current Resources for Evidence-Based Practice, May 2019. J Obstet Gynecol Neonatal Nurs 2019; 48:361-371. [DOI: 10.1016/j.jogn.2019.04.281] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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121
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Small cell carcinoma of cervix: A population-based study evaluating standardized provincial treatment protocols. Gynecol Oncol Rep 2019; 27:54-59. [PMID: 30723760 PMCID: PMC6348692 DOI: 10.1016/j.gore.2019.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 12/31/2018] [Accepted: 01/08/2019] [Indexed: 12/11/2022] Open
Abstract
Objectives To describe the patient characteristics, patterns of treatment, and outcome of patients with small cell carcinoma of Cervix (SmCC) treated with radical radiotherapy from a provincial cancer registry database. Methods Overall 25 patients with SmCC were treated with radical radiotherapy (with or without chemotherapy) from January 1, 1994 to December 31, 2013. Nineteen patients had pure SmCC while 6 had additional neuroendocrine component. Patients were treated with combined chemo-radiotherapy using multi-agent chemotherapy with pelvic or combined pelvic and para-aortic radiotherapy. All patients received brachytherapy. Use of prophylactic cranial irradiation was dependent on physician discretion. Survival was estimated using Kaplan-Meier method and compared using log-rank test. Results We report a median overall survival of 53.8 months for our cohort. After a median follow-up of 54 months for surviving patients, the overall survival (OS) and progression free survival (PFS) at 5-years were 48% and 46.4% respectively. Patients with stage I-IIA disease had superior 5-year PFS (67.3% vs. 11.1%; p = .004) and 5-year OS (62.5% vs. 22.2%; p = .006). Patients with node-negative disease had a trend towards better 5-year PFS (55.7% vs. 19%; p = .07) and OS (61.1% vs. 14.3% at 5-years; p = .06) Distant metastasis was the predominant site of disease progression (n = 12; 48%). Conclusion Distant metastasis is the predominant pattern of failure for patients with SmCC treated with radical chemo-radiotherapy. With modern chemo-radiotherapy protocols we can expect a 5 year survival of around 50%. Early stage and node-negative status appear to be favorable prognostic factors with survival rates at 5-year over 60%. Multi-agent chemotherapy with radiotherapy results in 50% overall survival at 5-years in small cell carcinoma of cervix Distant metastasis remains the predominant site of disease progression Stage and node-involvement bears significant association with survival
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Lee E, Ji YI. Large Cell Neuroendocrine Carcinoma of the Cervix with Sequential Metastasis to Different Sites: A Case Report. Case Rep Oncol 2018; 11:665-670. [PMID: 30483095 PMCID: PMC6243902 DOI: 10.1159/000493912] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 09/19/2018] [Indexed: 11/19/2022] Open
Abstract
Neuroendocrine carcinoma of the cervix is rare, and prognosis is very poor. Because of its rarity, effective treatment of neuroendocrine carcinoma of the cervix has not been established. It has distinct patterns of metastasis, but can be successfully treated with radical surgery and platinum-based chemotherapy. We report a 50-year-old woman who was diagnosed with large cell neuroendocrine carcinoma of the cervix and underwent radical surgery followed by adjuvant chemoradiation therapy. She experienced recurrence several times and to different sites, with sequential metastasis to the lung, breast, and retroperitoneum, but nevertheless survived more than 5 years.
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Affiliation(s)
- Eunhyun Lee
- Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
| | - Yong-Il Ji
- Department of Obstetrics and Gynecology, Inje University Haeundae Paik Hospital, Busan, Republic of Korea
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