Small cell neuroendocrine carcinoma of the cervix: Analysis of prognostic factors and patterns of metastasis
Objectives: To describe characteristics and outcomes of patients with small cell neuroendocrine carcinoma of the cervix (SCNCC) and determine the staging system most predictive of outcome—the two-tier (limited-stage [LS] vs. extensive-stage [ES]) or International Federation of Gynecology and Obstetr...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2022-10-01
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| Series: | Gynecologic Oncology Reports |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2352578922001382 |
| _version_ | 1798020615471366144 |
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| author | Sushmita Gordhandas Brooke A. Schlappe Qin Zhou Alexia Iasonos Mario M. Leitao, Jr. Kay J. Park Louise de Brot Kaled M. Alektiar Paul J. Sabbatini Carol A. Aghajanian Claire Friedman Oliver Zivanovic Roisin E O'Cearbhaill |
| author_facet | Sushmita Gordhandas Brooke A. Schlappe Qin Zhou Alexia Iasonos Mario M. Leitao, Jr. Kay J. Park Louise de Brot Kaled M. Alektiar Paul J. Sabbatini Carol A. Aghajanian Claire Friedman Oliver Zivanovic Roisin E O'Cearbhaill |
| author_sort | Sushmita Gordhandas |
| collection | DOAJ |
| description | Objectives: To describe characteristics and outcomes of patients with small cell neuroendocrine carcinoma of the cervix (SCNCC) and determine the staging system most predictive of outcome—the two-tier (limited-stage [LS] vs. extensive-stage [ES]) or International Federation of Gynecology and Obstetrics (FIGO) staging system. Methods: Patients with SCNCC evaluated at our institution from 1/1/1990–6/30/2021 were included. Medical records were reviewed for variables of interest. Appropriate statistical tests were performed to determine associations. Survival curves were created using the Kaplan-Meier method. Concordance probability estimates (CPEs) were calculated to evaluate the prediction probability of the staging systems. Results: Of 63 patients, 41 had LS and 22 ES SCNCC. Patients with ES disease were significantly older than those with LS disease (median, 54 and 37 years, respectively; p < 0.001). Smoking status, race, and history of HPV were not associated with stage or outcomes. Forty-eight patients had metastatic disease (24 [50%] at initial diagnosis). The most common first sites of metastasis were lung (n = 20/48, 42%), lymph nodes (n = 19/48, 40%), and liver (n = 13/48, 27%). Nine patients had brain metastasis (8 symptomatic at recurrence; 1 asymptomatic at initial diagnosis). Both staging systems were associated with progression-free and overall survival. Adjusted CPE found the FIGO staging system was more predictive of outcomes than the two-tier staging system. Conclusions: Providers should have a low threshold to obtain brain imaging for patients with SCNCC, especially in the presence of visceral metastases. FIGO staging should be used to classify SCNCC. Further research is necessary to understand prognostic factors of this rare disease. |
| first_indexed | 2024-04-11T17:00:21Z |
| format | Article |
| id | doaj.art-994ad548680a4c9b965eec774ef38912 |
| institution | Directory Open Access Journal |
| issn | 2352-5789 |
| language | English |
| last_indexed | 2024-04-11T17:00:21Z |
| publishDate | 2022-10-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Gynecologic Oncology Reports |
| spelling | doaj.art-994ad548680a4c9b965eec774ef389122022-12-22T04:13:10ZengElsevierGynecologic Oncology Reports2352-57892022-10-0143101058Small cell neuroendocrine carcinoma of the cervix: Analysis of prognostic factors and patterns of metastasisSushmita Gordhandas0Brooke A. Schlappe1Qin Zhou2Alexia Iasonos3Mario M. Leitao, Jr.4Kay J. Park5Louise de Brot6Kaled M. Alektiar7Paul J. Sabbatini8Carol A. Aghajanian9Claire Friedman10Oliver Zivanovic11Roisin E O'Cearbhaill12Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USAGynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Currently at: Gynecologic Oncology, Department of Surgery, Aurora Health Care, Milwaukee, WI, USADepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USADepartment of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, USAGynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USADepartment of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USAA.C. Camargo Cancer Center, Anatomic Pathology Department, São Paulo, BrazilDepartment of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, NY, USAGynecologic Medical Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USAGynecologic Medical Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USAGynecologic Medical Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USAGynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of OB/GYN, Weill Cornell Medical College, New York, NY, USAGynecologic Medical Oncology, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA; Department of Medicine, Weill Cornell Medical College, New York, NY, USA; Corresponding author: Gynecology Medical Oncology Service, Department of Medicine, Memorial Sloan Kettering Cancer Center, 1275, York Avenue, New York, NY 10065, USA.Objectives: To describe characteristics and outcomes of patients with small cell neuroendocrine carcinoma of the cervix (SCNCC) and determine the staging system most predictive of outcome—the two-tier (limited-stage [LS] vs. extensive-stage [ES]) or International Federation of Gynecology and Obstetrics (FIGO) staging system. Methods: Patients with SCNCC evaluated at our institution from 1/1/1990–6/30/2021 were included. Medical records were reviewed for variables of interest. Appropriate statistical tests were performed to determine associations. Survival curves were created using the Kaplan-Meier method. Concordance probability estimates (CPEs) were calculated to evaluate the prediction probability of the staging systems. Results: Of 63 patients, 41 had LS and 22 ES SCNCC. Patients with ES disease were significantly older than those with LS disease (median, 54 and 37 years, respectively; p < 0.001). Smoking status, race, and history of HPV were not associated with stage or outcomes. Forty-eight patients had metastatic disease (24 [50%] at initial diagnosis). The most common first sites of metastasis were lung (n = 20/48, 42%), lymph nodes (n = 19/48, 40%), and liver (n = 13/48, 27%). Nine patients had brain metastasis (8 symptomatic at recurrence; 1 asymptomatic at initial diagnosis). Both staging systems were associated with progression-free and overall survival. Adjusted CPE found the FIGO staging system was more predictive of outcomes than the two-tier staging system. Conclusions: Providers should have a low threshold to obtain brain imaging for patients with SCNCC, especially in the presence of visceral metastases. FIGO staging should be used to classify SCNCC. Further research is necessary to understand prognostic factors of this rare disease.http://www.sciencedirect.com/science/article/pii/S2352578922001382Cervical cancerSmall cell neuroendocrine carcinoma of the cervixStagingMetastasisPrognosis |
| spellingShingle | Sushmita Gordhandas Brooke A. Schlappe Qin Zhou Alexia Iasonos Mario M. Leitao, Jr. Kay J. Park Louise de Brot Kaled M. Alektiar Paul J. Sabbatini Carol A. Aghajanian Claire Friedman Oliver Zivanovic Roisin E O'Cearbhaill Small cell neuroendocrine carcinoma of the cervix: Analysis of prognostic factors and patterns of metastasis Gynecologic Oncology Reports Cervical cancer Small cell neuroendocrine carcinoma of the cervix Staging Metastasis Prognosis |
| title | Small cell neuroendocrine carcinoma of the cervix: Analysis of prognostic factors and patterns of metastasis |
| title_full | Small cell neuroendocrine carcinoma of the cervix: Analysis of prognostic factors and patterns of metastasis |
| title_fullStr | Small cell neuroendocrine carcinoma of the cervix: Analysis of prognostic factors and patterns of metastasis |
| title_full_unstemmed | Small cell neuroendocrine carcinoma of the cervix: Analysis of prognostic factors and patterns of metastasis |
| title_short | Small cell neuroendocrine carcinoma of the cervix: Analysis of prognostic factors and patterns of metastasis |
| title_sort | small cell neuroendocrine carcinoma of the cervix analysis of prognostic factors and patterns of metastasis |
| topic | Cervical cancer Small cell neuroendocrine carcinoma of the cervix Staging Metastasis Prognosis |
| url | http://www.sciencedirect.com/science/article/pii/S2352578922001382 |
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