Exploring the ‘Rare’: A Comprehensive Analysis of the Rare Malignant Cervical Tumors in a Tertiary Cancer Care Institute of Northeast India

Abstract

Introduction The WHO 2020 classification of tumors of the female genital tract has adopted the dualistic classification of cervical squamous and adenocarcinoma into HPV–HPV-associated and HPV–HPV-independent types. However, the separate discussion on 'rare' varieties of cervical cancer is significant as it allows us to delve into their risk factors and natural course of disease and define any alternative treatment strategies to improve outcomes. Objectives To estimate the factors associated with histologically proven rare malignant tumors of the cervix and the overall survival of rare malignant cervical tumors in a tertiary care institute of Northeast India (NEI). Methods Our tertiary care institute in Northeast India, a region with unique healthcare challenges, including a high incidence of cervical cancers, conducted this retrospective study from 01/01/2018 to 31/12/2022. It excluded patients with incomplete records, squamous and adenocarcinoma histology, and metastatic cancer to the cervix. We collected demographic and survival data and performed survival analysis using SPSS 29.0. Results Out of 2367 diagnosed cervical cancer patients, 45 patients (1.9%) were diagnosed with rare cancer. Adenosquamous (0.7%) was the leading histology, followed by small cell NET (0.59%) and clear cell carcinoma (0.33%) in rare cervical cancer. Bleeding per vaginum was the presenting symptom in 91%. More than 80% of patients had a short duration of illness (< 6 months). Stage III (42%), followed by Stage II (27%), Stage IV (21%), and Stage I (10%) were presenting stages. A final diagnosis in 72% of histology required immunohistochemistry (IHC). Most of the patient (65%) did not complete their treatment. Conclusion This study's findings underscore the need for collective efforts in studying rare cancers, which can significantly enhance treatment strategies and improve the overall prognosis and quality of life for individuals affected.