Pathological types affect survival outcomes in patients with surgically
treated high-grade neuroendocrine carcinoma of the cervix: A
multicenter, retrospective study
Abstract
Objective: An evaluation of the prognostic factors of patients with
surgically treated high-grade neuroendocrine carcinoma of the cervix
(NECC). Design: A multi-center, retrospective analysis Setting and
Population: 58 cases Methods: 58 patients with stage IIA1-IIIC cervical
cancer who had high-grade NECC and were initially treated with surgery
between 2009 and 2022 was conducted. We divided them into two groups
based on pathology: the pure cohort (only one histological type) and the
mixed group (≥2 histological types). All clinicopathological
characteristics of patients were reviewed retrospectively using
electronic medical records. Main Outcome Measures: Survival outcomes of
NECC, clinicopathological characteristics and various related factors
were analysed. Results: The median overall survival (OS) was 32.5 months
(range: 4.1–60.9). The mixed pathology was a protective factor
impacting survival outcomes in NECC (HR,0.02; 95% CI,
0.00~0.45, P=0.014). In contrast, uterus invasion (HR,
24.5; 95%CI, 1.37~439.31, P=0.03) was a poor prognostic
factor affecting the survival outcomes in NECC. In addition, among all
postoperative adjuvant chemotherapy options, etoposide + platinum (EP)
showed better survival outcome (HR,0.04; 95% CI,
0.00~0.89, P=0.041). According to the Kaplan-Meier
survival curves, significant differences were observed with respect to
mixed pathology (P=0.044), uterus invasion (P<0.0001), parametrium
invasion (P=0.025), surgical margin (P=0.035), and distant metastasis
(P<0.0001). Conclusions: Patients with mixed pathological subtypes who
undergo surgery for NECC have a better prognosis. Meanwhile, uterus
invasion is a poor predictor of prognosis. In terms of postoperative
adjuvant chemotherapy, the EP regimen is superior to other regimens.
(The trial registration number: ChiCTR2200063023)