The Analysis Of Neoadjuvent Chemotherapy For Small Cell Carcinoma Of The Uterine Cervix

Objective Through analyzing the clinical and pathologic characters andthe treatment to reveal the function of Neoadjuvant chemotherapy to smallcell neuroendocrine carcinoma of the cervix (SCCC).Methods We performed a retrospective analysis of10897patients frompatients with cervical cancer from the cervical cancer database v1.10(http://clinicaltrials.gov; NCT01267851)， and selected30patients withSCCC. We checked the information of these patients including age、 chiefcomplaint、 menstrual history、 family tumor history、 size of cervicaltumor、 FIGO stage、 status of lymph node metastasis and made the follow-upof them. Analyzed the possible risk factors of prognosis,and mainlyanalyzed the effect of neoadjuvant chemotherapy including short-termresponse and long-term impact of survival.Results The mean age of30patients with SCCC is40.2years old. Numberof FIGO stage IB1、IB2、 IIA、 IIB、 IIIB and IV is11、7、4、4、1and3respectly. Among them，including23pure SCCC and7mixed SCCC. Inthe patients who have information of follow-up, early FIGO stage (IA-IIA)18cases、 advanced FIGO stage（IIB-IV）4cases，3-year disease-freesurvival （DFS）time is40.7months and9months respectly,3-year DFSrate is68.0%and0.0%, P=0.003respectly；3-year overall survival （OS）time is43.9months and11.8months respectly,3-year OS rate is68.0%and0.0%, P=0.001respectly.In the COX ‘s Proportional Hazard Model，advanced FIGO stage proved to be the independent risk factor in3-yearDFS and3-year OS (P=0.017and0.006respectly).3-year DFS time oflymphovascular space invasion (LVI) positive and negative is40.9monthsand13.7months res pectly;3-year DFS rate of LVI positive and negativeis64.2%and20.8%, P=0.089, respectly;3-year OS time of lymphovascularspace invasion (LVI) positive and negative is45.0months and16.6months res pectly;3-year OS rate of LVI positive and negative is73.3%and0.0%,P=0.031, respectly. In the9patients who received neoadjuvantchemotherapy,8had response (complete response and partial response),1did not have response (stable and progress), response rate is88.9%.Neoadjuvant chemotherapy had not effect to tumor size、 lymphovascularspace invasion and other factors， but it showed the ability of distantrecurrence control, P=0.029. The3-year OS rate of early FIGO stage andadvanced FIGO stage is60.0%,0.0%, P=0.006, respectly. The3-year OS rateof lymphovascular space invasion positive and negative is60.0%,0.0%,P=0.017, respectly. The3-year OS rate of2/3cervical stromal invasionpositive and negative is75.0%,0.0%, P=0.058, respectly.Conclusion Advanced FIGO stage proved to be the independent risk factorto Small cell neuroendocrine carcinoma of the cervix (SCCC). SCCC issensitive to neoadjuvant chemotherapy. Neoadjuvant chemotherapy has noeffect to risk factors of common cervical cancer and could not improvesurvival rate of patients with SCCC, but it has the effect of controllingdistant recurrence.