Analysis Of The Prognostic Factors For Small Cell Neuroendocrine Carcinoma Of The Uterine Cervix

Objective: To evaluate the clinical characteristics,pathological characteristics and treatment mode of small cell neuroendocrine carcinoma of the cervix(SCNEC)on the impact of prognosis.To explore prognostic risk factors and more effective treatment of SCNEC,and provide theoretical basis for the clinical diagnosis and treatment of SCNEC.Methods: Part one:A comprehensive search was performed in PubMed、EMbase、Cochrane Library、CNKI、WanFang Data、CBM and VIP databases to retrieve studies on the clinical prognosis of SCNEC published in China and abroad as of March 1,2019,and 18 literatures with 1788 SCNEC patients were analyzed.HR and 95%CI related to survival analysis of prognostic factors and total survival were extracted and meta-analysis was carried out with 12.0 Stata software.Part two : To retrospectively analyze the clinical and pathological characteristics of 39 patients with SCNEC who underwent surgical treatmentfrom December 2008 to November 2018 in the Department of Gynecology and Oncology,Affiliated Tumor Hospital of Guangxi Medical University,and discusse the prognostic factors and treatment patterns of SCNEC。Results: Part one:The Meta-analysis showed that FIGO stage,tumor size,depth of stromal invasion,lymphovascular space involvement,lymph node metastasis,parauterine involvement,positive surgical margin,adjuvant chemotherapy and adjuvant radiotherapy were correlated with the prognosis of SCNEC,but age,pathological components and neoadjuvant chemotherapy were not.Part two : Univariate analysis showed that,tumor size,depth of stromal invasion,lymphovascular space involvement,lymph node metastasis and courses of chemotherapy after operation were related to prognosis,but surgical approach,age,FIGO stage,pathological components,neoadjuvant chemotherapy,preoperative adjuvant therapy and postoperative chemotherapy regimen are not related to prognosis of SCNEC.Multivariate analysis showed that lymphovascular space involvement,depth of stromal invasion and lymph node metastasis are independent risk factors for OS in SCNEC patients.Conclusion: Part one: 1.FIGO staging,tumor size,depth of cervical interstitial invasion,lymphatic vessel space infiltration,lymph node metastasis,parauterine invasion and surgical margin are related to the prognosis of SCNEC,but age and pathological components were not related to the prognosis of SCNEC.2.Postoperative adjuvant chemotherapy could elevate the overall OS of SCNEC.Neoadjuvant chemotherapy and postoperative adjuvant radiotherapycan not significantly improve the overall OS of SCNEC.Part two:Lymphovascular space involvement,depth of stromal invasion and lymph node metastasis were independent risk factors for OS in SCNEC patients.