scholarly journals Data from small cell neuroendocrine carcinoma of the cervix: FIGO 2018 staging is more accurate than FIGO 2009

2022 ◽  
Vol 50 (1) ◽  
pp. 030006052110673
Author(s):  
Yunqiang Zhang ◽  
Jingxin Ding ◽  
Keqin Hua
Keyword(s):  
Neuroendocrine Carcinoma ◽  
Abdominal Cavity ◽  
Small Cell ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iiic ◽  
Small Cell Neuroendocrine Carcinoma ◽  
Local Invasion ◽  
Invasion Stage ◽  
Staging Systems

Objective To compare the prognostic value of International Federation of Gynecology and Obstetrics (FIGO) 2009 and 2018 staging systems in surgical patients with small cell neuroendocrine carcinoma of the cervix (SCNEC). Methods We re-staged 64 surgical IB–IIA (FIGO 2009) SCNEC patients according to the FIGO 2018 system and refined stage IIIC of FIGO 2018 based on tumor local invasion. The prognostic factors were analyzed, and the advantages of FIGO 2018 were compared with 2009. Results The 5-year overall survival rate (OS) was 78.5% for stage I and 22.2% for stage II (FIGO 2009). In FIGO 2018, there was no difference between stage I and II, and the 5-year OS was 74.1%, 60.2%, and 0% for stage I/II, IIIC1, and IIIC2. After combining stage IIIC with the local invasion stage (T1 was limited to the cervix and vagina; T2 involved the parametrium; T3 involved the pelvic or abdominal cavity), the 5-year OS for stage IIICT1, IIICT2, and IIICT3 was 83.3%, 30.0%, and 0%, respectively. Conclusions For stage II SCNEC patients, FIGO 2009 underestimated the prognosis, while FIGO 2018 was more accurate. For stage IIIC, FIGO 2018 might be more individualized and accurate after combining stage IIIC with tumor local invasion.

scholarly journals Prognostic factors of FIGO stage I-IIA small-cell neuroendocrine carcinoma of the uterine cervix

2018 ◽  
Vol 142 (3) ◽  
pp. 374-375 ◽  
Author(s):  
Li Ning ◽  
Wen Zhang ◽  
Jiaxin Yang ◽  
Dongyan Cao ◽  
Jinghe Lang ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Neuroendocrine Carcinoma ◽  
Uterine Cervix ◽  
Figo Stage ◽  
Small Cell ◽  
Stage I ◽  
Small Cell Neuroendocrine Carcinoma

scholarly journals Data from small cell neuroendocrine carcinoma of cervix: FIGO 2018 staging is more accurate than FIGO 2009

2020 ◽  
Author(s):  
Yunqiang Zhang ◽  
Jingxin Ding ◽  
Keqin Hua
Keyword(s):  
Abdominal Cavity ◽  
Univariate Analysis ◽  
Staging System ◽  
Figo Stage ◽  
Small Cell ◽  
Stage I ◽  
Stage Iiic ◽  
Gynecology And Obstetrics ◽  
Carcinoma Of Cervix ◽  
Parametrial Involvement

Abstract Background: To evaluate whether the addition of stage IIIC to the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system of cervical cancer is reasonable based on small cell neuroendocrine carcinomas of cervix (SCNEC) data.Methods: We retrospectively reviewed 64 SCNEC patients with FIGO 2009 stage IB–IIA from January 2014 to December 2018 at the author’s hospital.Results: Univariate analysis showed that FIGO 2018 was related to more prognostic factors than FIGO 2009. Multivariate analysis showed the FIGO stage and the degree of lymph node metastasis (LNM) were significantly related to the prognosis of SCNEC patients. The 5-year overall survival rate (OS) was 78.5% and 22.2% in stage I and II, respectively (FIGO 2009). In FIGO 2018, the 5-year OS was 74.1%, 60.2%, and 0% in stage I/II, IIIC1, and IIIC2, respectively. After IIIC stage was subgrouped by T factor (T1, limited to cervix and vagina; T2, parametrial involvement; T3, pelvic and abdominal cavity involvement), the 5-year OS of IIICT1,IIICT2, and IIICT3 was 83.3%, 30.0%, and 0%, respectively, (P=0.010); while by N factor (N1a and N1b, metastasis to pelvic with the rate ≤0.20 and >0.20; N1c, metastasis to the para-aortic), the 5-year OS of IIICN1a, IIICN1b, and IIICN1c was 80.0%, 26.7%, and 0%, respectively (P=0.016).Conclusion: Compared with FIGO 2009, FIGO 2018 can evaluate the prognosis of SCNEC patients more accurately after subdivision of stage IIIC by combining tumor local invasion factors or the degree and location of LNM.

Cardiac transthyretin wild-type amyloidosis (ATTRwt): a prospective study of 400 patients followed at the Italian referral center

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
P Milani ◽  
L Obici ◽  
R Mussinelli ◽  
M Basset ◽  
G Manfrinato ◽  
...  
Keyword(s):  
Natural History ◽  
Median Survival ◽  
Troponin I ◽  
Stage I ◽  
Stage Ii ◽  
Stage Iii ◽  
Wild Type ◽  
Staging Systems ◽  
Significant Difference ◽  
History Of

Abstract Background Cardiac wild type transthyretin (ATTRwt) amyloidosis, formerly known as senile systemic amyloidosis, is an increasingly recognized, progressive, and fatal cardiomyopathy. Two biomarkers staging systems were proposed based on NT-proBNP (in both cases) and troponin or estimated glomerular filtration rate, that are able to predict survival in this population. The availability of novel effective treatments requires large studies to describe the natural history of the disease in different populations. Objective To describe the natural history of the disease in a large, prospective, national series. Methods Starting in 2007, we protocolized data collection in all the patients diagnosed at our center (n=400 up to 7/2019). Results The referrals to our center increased over time: 5 cases (1%) between 2007–2009, 33 (9%) in 2010–2012, 90 (22%) in 2013–2015 and 272 (68%) in 2016–2019. Median age was 76 years [interquartile range (IQR): 71–80 years] and 372 patients (93%) were males. One hundred and seventy-three (43%) had atrial fibrillation, 63 (15%) had a history of ischemic cardiomyopathy and 64 (15%) underwent pacemaker or ICD implantation. NYHA class was I in 58 subjects (16%), II in 225 (63%) and III in 74 (21%). Median NT-proBNP was 3064 ng/L (IQR: 1817–5579 ng/L), troponin I 0.096 ng/mL (IQR: 0.063–0.158 ng/mL), eGFR 62 mL/min (IQR: 50–78 mL/min). Median IVS was 17 mm (IQR: 15–19 mm), PW 16 mm (IQR: 14–18 mm) and EF 53% (IQR: 45–57%). One-hundred and forty-eight subjects (37%) had a concomitant monoclonal component in serum and/or urine and/or an abnormal free light chain ratio. In these patients, the diagnosis was confirmed by immunoelectron microscopy or mass spectrometry. In 252 (63%) the diagnosis was based on bone scintigraphy. DNA analysis for amyloidogenic mutations in transthyretin and apolipoprotein A-I genes was negative in all subjects. The median survival of the whole cohort was 59 months. The Mayo Clinic staging based on NT-proBNP (cutoff: 3000 ng/L) and troponin I (cutoff: 0.1 ng/mL) discriminated 3 different groups [stage I: 131 (35%), stage II: 123 (32%) and stage III: 127 (33%)] with different survival between stage I and II (median 86 vs. 81 months, P=0.04) and between stage II and III (median 81 vs. 62 months, P<0.001). The UK staging system (NT-proBNP 3000 ng/L and eGFR 45 mL/min), discriminated three groups [stage I: 170 (45%), stage II: 165 (43%) and stage III: 45 (12%)] with a significant difference in survival: between stage I and stage II (86 vs. 52 months, P<0.001) and between stage II and stage III (median survival 52 vs. 33 months, P=0.045). Conclusions This is one of the largest series of patients with cardiac ATTRwt reported so far. Referrals and diagnoses increased exponentially in recent years, One-third of patients has a concomitant monoclonal gammopathy and needed tissue typing. Both the current staging systems offered good discrimination of staging and were validated in our independent cohort. Funding Acknowledgement Type of funding source: None

scholarly journals Mixed large and small cell neuroendocrine carcinoma and endometrioid carcinoma of the endometrium with high microsatellite instability: A case report and literature review

2021 ◽  
Vol 9 ◽  
pp. 2050313X2199920
Author(s):  
Kotaro Inoue ◽  
Kentaro Kai ◽  
Shimpei Sato ◽  
Haruto Nishida ◽  
Koji Hirakawa ◽  
...  
Keyword(s):  
Microsatellite Instability ◽  
Neuroendocrine Carcinoma ◽  
Immune Checkpoint Blockade ◽  
Japanese Woman ◽  
Endometrial Biopsy ◽  
Small Cell ◽  
Endometrioid Carcinoma ◽  
Small Cell Neuroendocrine Carcinoma ◽  
Mutation Burden ◽  
Solid Part

A 65-year-old, gravida 3, para 2 Japanese woman was referred to our hospital for symptomatic thickening of the endometrial lining. Endocervical and endometrial cytology revealed an adenocarcinoma. The endometrial biopsy specimen was mixed, with a glandular part diagnosed as endometrioid carcinoma and a solid part diagnosed as high-grade mixed large and small cell neuroendocrine carcinoma (L/SCNEC). She underwent extra-fascial hysterectomy with bilateral salpingo-oophorectomy, complete pelvic and para-aortic lymphadenectomy, and omentectomy (FIGO IIIB, pT3b pN0 M0). She currently has no deleterious germline mutation, but high tumor mutation burden and high microsatellite instability (MSI) were identified. She underwent six cycles of platinum-based frontline chemotherapy and achieved complete remission. Immune checkpoint blockade therapy is a promising second-line therapy for MSI-high solid tumors. However, the MSI or mismatch repair (MMR) status of endometrial L/SCNEC remains unclear in the literature. Universal screening for MSI/MMR status is needed, particularly for a rare and aggressive disease.

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