The importance of choosing the right strategy to treat small cell carcinoma of the cervix: a comparative analysis of treatments.
Adult
Aged
Aged, 80 and over
Antineoplastic Agents
/ therapeutic use
Carcinoma, Small Cell
/ mortality
Cause of Death
Chemoradiotherapy
Female
Humans
Japan
Kaplan-Meier Estimate
Middle Aged
Neoadjuvant Therapy
Neoplasm Staging
Proportional Hazards Models
Retrospective Studies
Uterine Cervical Neoplasms
/ mortality
Young Adult
Cervical cancer
Chemotherapy
Rare cancer
Small cell carcinoma
Journal
BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800
Informations de publication
Date de publication:
23 Sep 2021
23 Sep 2021
Historique:
received:
30
10
2020
accepted:
08
09
2021
entrez:
24
9
2021
pubmed:
25
9
2021
medline:
21
10
2021
Statut:
epublish
Résumé
Standard treatments for small cell carcinoma of the cervix (SCCC) have not been established. In this study, we aimed to estimate the optimal treatment strategy for SCCC. This was a multicenter retrospective study. Medical records of patients with pathologically proven SCCC treated between 2003 and 2016 were retrospectively analyzed. Overall survival (OS) was plotted using the Kaplan-Meier method. Log-rank tests and Cox regression analysis were used to assess the differences in survival according to stage, treatment strategy, and chemotherapy regimen. Data of 78 patients were collected, and after excluding patients without immunohistopathological staining, 65 patients were evaluated. The median age of the included patients was 47 (range: 24-83) years. The numbers of patients with International Federation of Gynecology and Obstetrics (FIGO) 2018 stages I-IIA, IIB-IVA, IVB were 23 (35%), 34 (52%), and 8 (12%), respectively. Of 53 patients who had undergone chemotherapy, 35 and 18 received SCCC and non-SCCC regimens as their first-line chemotherapy regimen, respectively. The 5-year OS for all patients was 49%, while for patients with FIGO stages I-IIA, IIB-IVA, IVB, it was 60, 50, and 0%, respectively. The 5-year OS rates for patients who underwent treatment with SCCC versus non-SCCC regimens were 59 and 13% (p < 0.01), respectively. This trend was pronounced in locally advanced stages. Multivariate analysis showed that FIGO IVB at initial diagnosis was a significant prognostic factor in all patients. Among the 53 patients who received chemotherapy, the SCCC regimen was associated with significantly better 5-year OS in both the uni- and multivariate analyses. Our results suggest that the application of an SCCC regimen such as EP or IP as first-line chemotherapy for patients with locally advanced SCCC may play a key role in OS. These findings need to be validated in future nationwide, prospective clinical studies.
Sections du résumé
BACKGROUND
BACKGROUND
Standard treatments for small cell carcinoma of the cervix (SCCC) have not been established. In this study, we aimed to estimate the optimal treatment strategy for SCCC.
METHODS
METHODS
This was a multicenter retrospective study. Medical records of patients with pathologically proven SCCC treated between 2003 and 2016 were retrospectively analyzed. Overall survival (OS) was plotted using the Kaplan-Meier method. Log-rank tests and Cox regression analysis were used to assess the differences in survival according to stage, treatment strategy, and chemotherapy regimen.
RESULTS
RESULTS
Data of 78 patients were collected, and after excluding patients without immunohistopathological staining, 65 patients were evaluated. The median age of the included patients was 47 (range: 24-83) years. The numbers of patients with International Federation of Gynecology and Obstetrics (FIGO) 2018 stages I-IIA, IIB-IVA, IVB were 23 (35%), 34 (52%), and 8 (12%), respectively. Of 53 patients who had undergone chemotherapy, 35 and 18 received SCCC and non-SCCC regimens as their first-line chemotherapy regimen, respectively. The 5-year OS for all patients was 49%, while for patients with FIGO stages I-IIA, IIB-IVA, IVB, it was 60, 50, and 0%, respectively. The 5-year OS rates for patients who underwent treatment with SCCC versus non-SCCC regimens were 59 and 13% (p < 0.01), respectively. This trend was pronounced in locally advanced stages. Multivariate analysis showed that FIGO IVB at initial diagnosis was a significant prognostic factor in all patients. Among the 53 patients who received chemotherapy, the SCCC regimen was associated with significantly better 5-year OS in both the uni- and multivariate analyses.
CONCLUSION
CONCLUSIONS
Our results suggest that the application of an SCCC regimen such as EP or IP as first-line chemotherapy for patients with locally advanced SCCC may play a key role in OS. These findings need to be validated in future nationwide, prospective clinical studies.
Identifiants
pubmed: 34556082
doi: 10.1186/s12885-021-08772-x
pii: 10.1186/s12885-021-08772-x
pmc: PMC8461987
doi:
Substances chimiques
Antineoplastic Agents
0
Types de publication
Comparative Study
Journal Article
Multicenter Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
1046Informations de copyright
© 2021. The Author(s).
Références
J Clin Oncol. 2003 Sep 15;21(18):3495-501
pubmed: 12972526
Gynecol Oncol. 2003 Mar;88(3):333-9
pubmed: 12648583
Eur J Cancer. 2012 Jul;48(10):1484-94
pubmed: 22244826
Gynecol Oncol. 2018 Jan;148(1):139-146
pubmed: 29113721
Cancer. 2003 Feb 1;97(3):568-74
pubmed: 12548598
Am J Obstet Gynecol. 2010 Oct;203(4):347.e1-6
pubmed: 20579961
Gynecol Oncol. 2009 Mar;112(3):590-3
pubmed: 19110302
Ann Oncol. 2008 Feb;19(2):321-6
pubmed: 17962205
N Engl J Med. 2002 Jan 10;346(2):85-91
pubmed: 11784874
Int J Gynaecol Obstet. 2009 May;105(2):103-4
pubmed: 19367689
Gynecol Oncol. 2004 Apr;93(1):27-33
pubmed: 15047210
Int J Gynecol Cancer. 2018 Nov;28(9):1751-1757
pubmed: 30358701
Gynecol Oncol. 2013 Jun;129(3):522-7
pubmed: 23480872
Gynecol Oncol. 2011 Jul;122(1):190-8
pubmed: 21621706
Cancer. 2000 Sep 15;89(6):1291-9
pubmed: 11002225