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J Korean Soc Ther Radiol Oncol > Volume 22(2); 2004 > Article
The Journal of the Korean Society for Therapeutic Radiology and Oncology 2004;22(2): 124-129.
Clinical Characteristics and Treatment Results of Neuroendocrine Carcinoma of Uterine Cervix
Ok Bae Kim, Jin Hee Kim, Soon Do Cha, Tae Jin Choi, Ji Won Ye
1Department of Radiation Oncology, Keimyung University School of Medicine, Daegu, Korea. obkim500@dsmc.or.kr
2Department of Gynecology and Obstetric, Keimyung University School of Medicine, Daegu, Korea.
3Department of Medical Biophysics Engineering, Keimyung University School of Medicine, Daegu, Korea.
4Department of Radiation Oncology, Catholic Unversity School of Medicine, Daegu, Korea.
ABSTRACT
PURPOSE:
To evaluate the clinical findings, prognosis and treatment strategy of patients with neuroendocrine carcinoma of cervix. MATERIALS AND MEHTODS: Thirteen patients with neuroendocrine carcinoma of cervix were included in this study, as confirmed histologically and immunohistochemically at the Dongsan Medical Center, Keimyung University, between May 1944 and October 2001. The mean age of patients was 56 years with a range of 32 to 78 years of age. According to the FIGO staging system, there were 5 patients with stage IB carcinoma, 5 patients with IIA, and 3 patients with stage IIB. Four patients underwent radical hysterectomy with pelvic lymphadenectomy, 3 of these patients also received postoperative radiotherapy, and one patient underwent extrafascial hysterectomy after radiotherapy. Primary radiotherapy was done in 9 patients, and 3 were irradiated postoperatively. Nine patients received chemotherapy, 7 received neoadjuvant and 2 received concurrent chemoradiotherapy. The radical purpose of radiotherapy consisted of external irradiation to the whole pelvis (4,500~5,400 cGy) and intracavitary irradiation (3,000~3,500 cGy).
RESULTS:
The mean follow up duration was 36 months with a range of 3 to 104 months. The overall 5-year survival rate was 61.5% and the 5-year survival rates for stage IB, IIA, IIB were 60.0%, 60.0%, and 66.7% respectively (p=0.99). Eight patients are still alive without disease, and all of the 5 patients with recurrence are dead due to distant metastasis.
CONCLUSION:
Neuroendocrine carcinoma of cervix is highly aggressive, with early lymphatic dissemination and a high rate of distant recurrence. Therefore, an aggressive therapeutic strategy is required to obtain pelvic and distant disease control. Multimodal therapy should be considered at the time of initial diagnosis.
Key Words: Neuroendocrine carcinoma, Uterine cervical carcinoma
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