UNASSIGNED: e15512 Background: High-grade neuroendocrine @entity2622 ( @entity2622 ) is a rare and aggressive @entity5 , and the optimal treatment remains uncertain. We report 36 cases seen at the University of Iowa between 1977 and 2010. METHODS: Cases were identified by searching our institutional database. Only @entity1 (pts) with pathology-confirmed @entity2622 were included. RESULTS: 36 cases with follow-up information were identified. The median age at diagnosis was 49 years (range 26 - 77). FIGO staging was @entity3846 for 14 pts (39%), IB2 for 3 (8%), II for 7 (19%), and 12 (34%) had stage III or higher. 17 pts (47.2%) underwent resection, 20 pts (56%) had @entity1161 ( @entity1161 ), and 27 pts (82%) received chemotherapy (ChT). The @entity1349 ( @entity1349 ) for the entire cohort was 20.7 months (ms) with 23% 5-year overall survival (5-OS) and 8% 10-year OS. Stage was a strong predictor of survival. Pts with stage @entity3846 or less had longer @entity1349 and 5-OS compared to those with higher stage ( @entity1349 42 vs. 11.1 ms, p=0.008, 5-OS 47 vs. 6%). Complete resection predicted better outcome ( @entity1349 : 50 vs 9.3 ms, p=0.0004, 5-OS: 50 vs. 0%). Of 17 resected pts, 7 recurred after a median of 19.4 ms (range 7.5 - 43), and all but 1 died. @entity1161 was not associated with outcome regardless of surgery. Resected pts had @entity1349 of 43.8 ms with @entity1161 vs. 128.5 ms without @entity1161 , (p=0.76). Pts with unresectable disease demonstrated @entity1349 of 11.8 ms with, and 10.5 ms without @entity1161 (p=0.8). ChT was beneficial in pts with unresectable disease. Pts receiving ChT had @entity1349 of 10.8 ms vs. 2.7 ms (p=0.006) in those who did not. None of these pts survived > 5 years. @entity902 with @entity2879 was used in 73%. Partial response or stable disease were seen in 50% with mean duration of response of 9.1 ms. Second line ChT at progression was used in 44.4%. Pre- and post-operative ChT in resectable disease did not impact survival ( @entity1349 45 ms on ChT vs. 156.5 ms with no ChT (p=0.37). CONCLUSIONS: The prognosis of advanced @entity2622 is very poor and surgery in early stages resulted in the best outcome. @entity1161 was not associated with improved survival in this study. ChT seems beneficial in unresectable disease, but the effect of the second line ChT remains undefined. Overall, the treatment outcomes remain unsatisfactory; better treatment options are needed.

High-grade neuroendocrine XXXX : Outcomes and the role of chemotherapy.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['cancer'] @entity1161 :: ('MESH:D011832', 'Disease') :: ['radiation therapy', 'RT'] @entity2622 :: ('MESH:D002583', 'Disease') :: ['carcinoma of the uterine cervix', 'cNEC'] @entity2879 :: ('MESH:D005047', 'Chemical') :: ['etoposide'] @entity3846 :: ('9479', 'Gene') :: ['IB1'] @entity902 :: ('MESH:D010984', 'Chemical') :: ['Platinum'] @entity1349 :: ('MESH:D011475', 'Disease') :: ['median survival', 'MS']
@entity2622 :: (MESH:D002583,Disease) :: ['carcinoma of the uterine cervix']
