Prognostic Factors For Small Cell Neuroendocrine Carcinoma Of The Uterine Cervix With Operative Treatment In Early-Stage Disease

Objective: To carry out the meta-analysis about prognostic factors of small cell neuroendocrine cervical carcinoma(SCNEC)with operative treatment in early-stage(IB1-IIA)disease.Methods: 16 articles which contains 73 patients about small cell neuroendocrine carcinoma of the uterine cervix(SCNEC)are reviewed in PUBMED、EMBASE、COCHRANE-LIBARY、CBM、CNKI.Meta-analysis was carried out about the prognostic factors such as age,FIGO stage,tumor size,lymph node metastasis,neoadiuvant chemotherapy,chemotherapy and radiotherapy.Results: Univariate analysis of 73 patients with SCNEC found FIGO stage significantly affacted the prognosis(P=0.001).Multivariate COX regression analysis found FIGO stage was important prognostic factor,HR=0.266(95%CI:0.132 0.536,P=0.000).The 3-year survival rates for IB1 stage and IB2-IIA stage were 63% and 19%.Single factor and multiple factors have got that FIGO stage could predict the poor prognosis.Lymph node metastasis was significant factor of SCNEC prognosis by univariate analysis(P=0.016)and multiple factor COX regression analysis HR=0.352(95%CI:0.175 0.705,P=0.003).The age and tumor size were confirmed effect-free for SCNEC prognosis with operative therapy.In the univariate analysis,chemotherapy affacted the prognosis(P=0.030),and multivariate COX regression analysis could get the same conclusion,HR=2.732(95%CI:1.052 7.097,P=0.039).There were no significant differences among neoadjuvant chemotherapy(P=0.171)and radiotherapy(P=0.082)in univariate analysis.multiple factors COX regression indicated that neoadjuvant chemotherapy(HR=1.892,95%CI : 0.761 4.701 P=0.436)and radiotherapy(HR=1.966,95%CI:0.938 4.120 P=0.141)were also no significant differences for SCNEC prognosis.In the early stage of SCNEC with operative therapy,the survival rate of IB1 stage with simple surgery may get better prognosis.Conclusion: FIGO stage,lymph node metastssis are significantly associated with the prognosis of SCNEC in IB1-IIA stage after operative therapy.In IB1 stage,simple surgery may get better prognosis in negative lymph-node patients.While IB2-IIA stage,chemotherapy was not necessary,and adjuvant radiotherapy should be noticed at some time.