J Gynecol Oncol.
2019 Nov;30(6):e103. 10.3802/jgo.2019.30.e103.
Clinicopathologic features, treatment, prognosis and prognostic factors of neuroendocrine carcinoma of the endometrium: a retrospective analysis of 42 cases from the Kansai Clinical Oncology Group/Intergroup study in Japan
- Matsumoto
- Shimokawa
- Nasu K
- Shikama A
- Shiozaki T
- Futagami M
- Kai K
- Nagano H
- Mori T
- Yano M
- Sugino N
- Fujimoto E
- Yoshioka N
- Nakagawa S
- Shimada M
- Tokunaga H
- Yamada Y
- Tsuruta T
- Tasaki K
- Nishikawa
- Kuji S
- Motohashi
- Ito K
- Yamada T
- Teramoto N
- Affiliations
-
- 1Department of Obstetrics and Gynecology, Faculty of Medicine, Oita University, Oita, Japan. matumoti@oita-u.ac.jp
- 2Cancer Biostatistics Laboratory, Clinical Research Institute, National Kyusyu Cancer Center, Fukuoka, Japan.
- 3Division of Obstetrics and Gynecology, Support System for Regional Medicine, Oita University, Oita, Japan.
- 4Department of Obstetrics and Gynecology, University of Tsukuba, Ibaraki, Japan.
- 5Division of Gynecology, Hyogo Cancer Center, Hyogo, Japan.
- 6Department of Obstetrics and Gynecology, Hirosaki University Graduate School of Medicine, Aomori, Japan.
- 7Department of Obstetrics and Gynecology, Tokyo Women's Medical University Medical Center East, Tokyo, Japan.
- 8Department of Obstetrics and Gynecology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
- 9Department of Pathology, Saitama Medical University International Medical Center, Saitama, Japan.
- 10Department of Obstetrics and Gynecology, Yamaguchi University Graduate School of Medicine, Yamaguchi, Japan.
- 11Division of Gynecology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan.
- 12Department of Obstetrics and Gynecology, St. Marianna University School of Medicine, Kanagawa, Japan.
- 13Department of Obstetrics and Gynecology, Osaka University, Osaka, Japan.
- 14Department of Obstetrics and Gynecology, Tottori University, Tottori, Japan.
- 15Department of Obstetrics and Gynecology, Tohoku University, Miyagi, Japan.
- 16Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
- 17Department of Obstetrics and Gynecology, Kansai Rosai Hospital, Hyogo, Japan.
- 18Department of Obstetrics and Gynecology, Kurume University, Fukuoka, Japan.
- 19Department of Obstetrics and Gynecology, Nagoya City University, Aichi, Japan.
- 20Department of Obstetrics and Gynecology, Kuwana City Medical Center, Mie, Japan.
- 21Department of Pathology, Osaka Medical College, Osaka, Japan.
- 22Division of Pathology, National Hospital Organization Shikoku Cancer Center, Ehime, Japan.
- KMID: 2458905
- DOI: http://doi.org/10.3802/jgo.2019.30.e103
Abstract
OBJECTIVE
We conducted a retrospective, multi-institutional, collaborative study to accumulate cases of neuroendocrine carcinoma of the endometrium, to clarify its clinicopathologic features, treatment, prognosis and prognostic factors to collate findings to establish future individualized treatment regimens. To our knowledge, this is the largest case study and the first study to statistically analyze the prognosis of this disease.
METHODS
At medical institutions participating in the Kansai Clinical Oncology Group/Intergroup, cases diagnosed at a central pathologic review as neuroendocrine carcinoma of the endometrium between 1995 and 2014 were enrolled. We retrospectively analyzed the clinicopathologic features, treatment, prognosis and prognostic factors of this disease.
RESULTS
A total of 65 cases were registered from 18 medical institutions in Japan. Of these, 42 (64.6%) cases were diagnosed as neuroendocrine carcinoma of the endometrium based on the central pathological review and thus included in the study. Advanced International Federation of Gynecology and Obstetrics stages (stage III and IV) and pure type small cell neuroendocrine carcinoma cases had a significantly worse prognosis. Upon multivariate analysis, only histologic subtypes and surgery were significant prognostic factors. Pure type cases had a significantly worse prognosis compared to mixed type cases and complete surgery cases had a significantly better prognosis compared to cases with no or incomplete surgery.
CONCLUSION
Our findings suggest that complete surgery improves the prognosis of neuroendocrine carcinoma of the endometrium. Even among cases with advanced disease stages, if complete surgery is expected to be achieved, clinicians should consider curative surgery to improve the prognosis of neuroendocrine carcinoma of the endometrium.
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