Clinical Characteristics of 23 Patients with Small Cell Carcinoma of the Uterine Cervix / 대한산부인과학회잡지

OBJECTIVES: To investigate clinicopathologic findings of patients with small cell carcinoma of uterine cervix, and to evaluate the recurrence pattern and prognosis of patients with small cell carcinoma of the uterine cervix. Methods: From Jan. 1990, to Dec. 1997, 23 patients with small cell carcinoma of the uterine cervix were registered and followed-up at Korea Cancer Center Hospital. Clinical characteristics, survival of these patients were studied retrospectively. RESULTS: Among the 23 cases of small cell carcinoma of uterine cervix, 17 cases(74%) were of the neuroendocrine type (NE group), and 6 cases(26.0%) of the squamous cell type (SCC group). The median age, FIGO stage, and treatment modality were not significant difference between two groups. Pelvic lymph node metastases were found 53% in NE group, and 33% in SCC group, but there were not significant difference between two groups(p>0.05). Three patients showed distant metastases in NE group(bone 18%, bladder 9%), but there was no distant metastasis in SCC group. The 3 year survival rate was 50.0% in SCC group and 32.1% in NE group, but there were not statistical significance(p>0.05). Six patients showed recurrence after treatment (4/17 cases in NE group, 2/6 cases in SCC group). Recurrence sites were liver (3/6, 50%), and lung (2/6, 33%), brain (2/6, 33%), retroperitoneum (1/6, 17%), and axillae lymph node (1/6, 17%). CONCLUSION: This study showed neuroendocrine small cell carcinoma may have more aggressive than squamous small cell carcinoma, but there were not significant difference in prognosis between the two groups. Because of limitation of number of patients, further large scaled multicenter studies are needed.

FDG-PET Scan in Patients with Cervical Cancer: Experience in Patients with Clinically No Evidence of Disease / 대한산부인과학회잡지

OBJECTIVE: The purpose of this study was to investigate the clinical feasibility of FDG-PET (Positron Emission Tomography) scan in patients with clinically no evidence of disease after treatment of cervical cancer. METHODS: One hundred and one patients with clinically NED(no evidence of disease) state after treatment of cervical cancer underwent PET scan. FDG-PET scan was obtained with a GE Advance Scanner, beginning at 50 minutes after injection of 370-555 MBq(10-15 mCi) of 18F FDG. Regional scan was also obtained with emission image. Uptake exceeding 3.0 SUV was determined as a positive finding. Recurrence was confirmed by CT, MRI, and needle biopsy if possible. RESULTS: Among 101 patients showing no evidence of disease, 17 patients(16.8%) showed abnormal PET scan findings. Clinically, 8 patients(7.9%) were confirmed to have recurrent lesion by CT, MRI or by needle biopsy. PET scan could detect recurrent lesions in the mediastinum or lung(10/17), pelvis(7/17), and supraclavicular lymph node(2/17). The sensitivity and specificity of PET scan in patients with cervical cancer showing no evidence of disease were 100% and 90.3%, respectively. The positive predictive value, negative predictive value and false positive rate were 47.1%, 100% and 52.9%. CONCLUSION: PET scan could detect 7.9% of early recurrence in patients with cervical cancer with NED status. FDG-PET scan may be a useful method in detecting metastases or recurrence of a cervical cancer showing no evidence of disease by routine conventional imaging studies.

Clinical Characteristics of 53 Patients with Recurrent Cervical Cancer Showing Lung Metastasis / 대한산부인과학회잡지

OBJECTIVE: Pulmonary metastasis from carcinoma of the uterine cervix is relatively rare, and their clinical outcomes are not still remain unknown. This study is to evaluate survival and prognostic factors in recurrent cervical cancer patients showing lung metastasis. METHODS: From Jan. 1993 to Dec. 1996, 53 recurrent cervical cancer patients showing lung metastasis, registered in Korea Cancer Center Hospital, were retrospectively evaluated with respect to their clinical characteristics, response rate to salvage therapy, survival and prognostic factors. RESULTS: Median age of patients at recurrence was 58 years, and median interval of initial diagnosis to recurrence was 17 months. The most common histologic type was squamous cell carcinoma(82%), followed by adenocarcinoma(6%), adenosquamous(6%), and others(6%). Response rate to salvage therapy was 47%(complete response rate 23.5%, partial response rate 23.5%), and median survival was 10 months(range 1-39). 3 year survival rate was 18%. Age, initial stage, initial tumor size, interval of recurrence and type of chemotherapeutic regimen were not significant prognostic factors, but squamous cell carcinoma antigen(SCC) level at recurrence and response to salvage therapy was significant(p=0.0087, p=0.0104). CONCLUSION: Survival of recurrent cervical cancer patients with lung metastasis was poor despite salvage therapy. Those patients who showed low SCC level at recurrence and good response to salvage therapy had favorable outcomes.