Clinicopathological Analysis of Neuroendocrine Carcinoma of the Uterine Cervix: A Single-Institution Retrospective Review of 9 Cases

Abstract

Aim. To evaluate the clinicopathological features affecting the recurrence and survival of 9 cases of neuroendocrine cancer of the cervix. Method. We retrospectively analyzed 9 cervical neuroendocrine cancer cases identified among 453 cervical cancer patients between 2004 and 2021 at Akdeniz University Gynecological Oncology Outpatient Clinic. Kaplan–Meier survival analysis was used for progression-free survival (PFS) and overall survival (OS). Mathematical functions of mean, standard deviation, median, Min–Max values, and frequencies were used for descriptive statistics. The categorical data were expressed in numbers and percentages (%). Results. Nine patients with neuroendocrine histological subtype were selected out of 453 patients diagnosed with cervical cancer (1.98%). The average overall survival time of the patients was 26 months. The 5-year survival rate was 53.3%, while the PFS was 62.5%. The most common subtype was small cell neuroendocrine cancer. Tumours were mostly locally advanced at the time of diagnosis. 3 patients’ stage was 1b2, while 4 patients were 2b, 1 patient was 3c2r, and 1 patient was 4b. All tumours showed the immunohistochemical staining properties of neuroendocrine cancer. The main treatment modality applied to our patients was surgery + adjuvant CRT. The most used chemotherapeutic agents were cisplatin/carboplatin and etoposide. Recurrence was found in 3 cases, including 5 deaths. Conclusion. Neuroendocrine tumour of the cervix is a rare subtype with a poor prognosis. Unfortunately, there is not yet a standard treatment protocol due to the limited number of comparative studies of surgery, chemotherapy, and radiotherapy based treatment schemes.

Small‐cell neuroendocrine carcinoma of the cervix accompanied by adenocarcinoma and high‐grade squamous intraepithelial lesion

“…This is mainly due to the rarity of cervical SCNECs 12 . Thus, cervical cytological specimens require a thorough cytological examination to detect SCNEC components when a cytological diagnosis of squamous cell carcinoma or HSIL and/or adenocarcinoma (invasive or in situ) is made; cervical SCNEC occasionally contains these components and shows aggressive clinical behavior 5 …”

“…adenocarcinoma, cervix, high-grade squamous intraepithelial lesion, small-cell neuroendocrine carcinoma Few reports have described small-cell neuroendocrine carcinoma (SCNEC) in the female genital tract. 1,2 While cervical SCNEC comprises 2-5% of all cervical cancers, [3][4][5] adenocarcinoma and/or squamous cell carcinoma components may be presented. [6][7][8][9] Here, we describe a case of cervical SCNEC accompanied by adenocarcinoma and high-grade squamous intraepithelial lesion (HSIL).…”