Abstract
BackgroundNeuroendocrine cervical carcinoma (NECC) is a rare but aggressive form of cervical cancer representing less than 3% of all cervical cancer cases. The objective of this study is to evaluate the effects of the clinicopathologic features and treatment modalities on the survival of patients with NECC.MethodsIn all, 89 stage I-IV patients with NECC that were diagnosed and treated between 2006 and 2014 at the Zhejiang Cancer Hospital were retrospectively recruited in this study. The Kaplan-Meier method, Cox regression analysis models and the log-rank test were used for the statistical analyses.ResultsNECC patients with advanced FIGO stage, tumor size > 4 cm, lymph node metastasis (LNM) and lymph-vascular space invasion (LVSI) were more likely to have significantly worse survival. Neither neo-adjuvant chemotherapy (NACT) nor radiotherapy (RT) was associated with improved overall survival. In the stratified analysis of stage I-IIA patients, those with advanced FIGO stage (P = 0.018), LNM (P = 0.008) and LVSI (P = 0.024) were associated with significantly worse survival. Patients without LNM who did not receive RT had significantly better survival rates than those who received RT (HR = 3.363, 95%CI = 1.245–10.619; P = 0.018). Moreover, for stage I-IIA patients with tumor size > 4 cm, NACT was not associated with a significantly better survival rate compared with no NACT (P = 0.600). None of the clinicopathologic features or treatment modalities was an independent prognostic factor in the multivariate analysis.ConclusionsIn conclusion, advanced FIGO stage, tumor size > 4 cm, LNM and LVSI were associated with poor survival. For stage I-IIA patients, RT should be carefully used in patients who are negative for LNM, and NACT may not be the optimal treatment for patients with tumor size > 4 cm.
Highlights
Neuroendocrine cervical carcinoma (NECC) is a rare but aggressive form of cervical cancer representing less than 3% of all cervical cancer cases
Clinicopathologic data including age, FIGO stage, tumor size, histologic type, lymph node metastasis (LNM), lymph–vascular space invasion (LVSI), depth of stromal invasion (DOI), and distant metastasis status were obtained by reviewing their medical records
Among the patients treated by radical hysterectomy, LNM and lymphvascular space invasion (LVSI) were found in 23 cases (31.5%) and 27cases (37%), respectively
Summary
Neuroendocrine cervical carcinoma (NECC) is a rare but aggressive form of cervical cancer representing less than 3% of all cervical cancer cases. Neuroendocrine cervical carcinoma (NECC) is a rare but aggressive form of cervical cancer, as it accounts for less than 3% of all cervical cancer cases [1]. For NECC tumors that are > 4 cm in size, neo-adjuvant chemotherapy (NACT) is recommended, followed by comprehensive treatment including surgery, once the tumor has been limited. These recommendations are based on limited data and are instructive for the basic treatment of NECC, but the complex treatment of NECC is not uniform in many places
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