Small cell neuroendocrine carcinoma of the cervix: Analysis of prognostic factors and patterns of metastasis

Gordhandas, Sushmita; Schlappe, Brooke A.; Zhou, Qin; Iasonos, Alexia; Leitao, Mario M.; Park, Kay J.; Brot, Louise De; Alektiar, Kaled M.; Sabbatini, Paul; Aghajanian, Carol; Friedman, Claire F.; Zivanovic, Oliver; O’Cearbhaill, Roisin E.

doi:10.1016/j.gore.2022.101058

Cited by 4 publications

(2 citation statements)

References 24 publications

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“…According to a previous report, the most common sites of first metastasis were the lung (42%) and lymph nodes (40%), followed by the liver (27%). [7]. Consistent with these findings, SCNEC of the uterine cervix is more likely to present at an advanced stage.…”

Section: Introductionsupporting

confidence: 70%

Population-Based Survival Analysis of Stage IVB Small-Cell Neuroendocrine Carcinoma in Comparison to Major Histological Subtypes of Cervical Cancer

Mabuchi,

Komura,

Sasano

et al. 2023

Current Oncology

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The aim of the current study is to investigate the survival outcome of stage IVB SCNEC of the uterine cervix in comparison to major histological subtypes of cervical cancer. A population-based retrospective cohort study was conducted using the Osaka Cancer Registry data from 1994 to 2018. All FIGO 2009 stage IVB cervical cancer patients who displayed squamous cell carcinoma (SCC), adenocarcinoma (A), adenosquamous cell carcinoma (AS), or small-cell neuroendocrine carcinoma (SCNEC) were first identified. The patients were classified into groups according to the types of primary treatment. Then, their survival rates were examined using the Kaplan–Meier method. Overall, in a total of 1158 patients, clearly differential survival rates were observed according to the histological subtypes, and SCNEC was associated with shortest survival. When examined according to the types of primary treatments, SCNEC was associated with significantly decreased survival when compared to SCC or A/AS, except for those treated with surgery. In patients with FIGO 2009 stage IVB cervical cancer, SCNEC was associated with decreased survival when compared to SCC or A/AS. Although current treatments with either surgery, chemotherapy or radiotherapy have some therapeutic efficacies, to improve the prognosis, novel effective treatments specifically targeting cervical SCNEC need to be developed.

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Section: Introductionsupporting

confidence: 70%

Population-Based Survival Analysis of Stage IVB Small-Cell Neuroendocrine Carcinoma in Comparison to Major Histological Subtypes of Cervical Cancer

Mabuchi,

Komura,

Sasano

et al. 2023

Current Oncology

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show abstract

“…Seino M et al found that for small cell neuroendocrine carcinoma of the cervix (SCNECC), tumors >4 cm in size had greater rates of lymph node and distant metastasis when compared with tumors </ = 4 cm [26]. Zhang X et al also confirmed advanced FIGO stage, tumor size > 4 cm, LNM, and LVSI were associated with poor survival for stage II SCNECC patients [27], while Gordhandas S et al revealed FIGO staging, rather than AJCC stage should be used to classify SCNECC [28]. Meta-analysis enrolled 20 studies funding FIGO staging, tumor size, parametrial involvement, resection margin, depth of stromal invasion, and LNM can be used as clinicopathological characteristics for the prediction of SCNECC prognosis [29].…”

Section: Plos Onementioning

confidence: 99%

Prognostic model for survival in patients with neuroendocrine carcinomas of the cervix: SEER database analysis and a single-center retrospective study

Yu,

Wu,

Zhang

et al. 2024

PLoS ONE

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Objective Neuroendocrine carcinoma of the cervix (NECC) is extremely rare in clinical practice. This study aimed to methodologically analyze the clinicopathological factors associated with NECC patients and to develop a validated survival prediction model. Methods A total of 535 patients diagnosed with NECC between 2004 and 2016 were identified from the Surveillance, Epidemiology and End Results (SEER) database, while 122 patients diagnosed with NECC at Yunnan Cancer Hospital (YCH) from 2006 to 2019 were also recruited. Patients from the SEER database were divided into a training cohort (n = 376) and a validation cohort (n = 159) in a 7:3 ratio for the construction and internal validation of the nomogram. External validation was performed in a cohort at YCH. The Kaplan-Meier method was used for survival analysis, the Log-rank method test was used for univariate analysis of prognostic influences, and the Cox regression model was used for multivariate analysis. Results The 3-year and 5-year overall survival (OS) rates for patients with NECC in SEER were 43.6% and 39.7%, respectively. In the training cohort, multivariate analysis showed independent prognostic factors for NECC patients including race, tumor size, distant metastasis, stage, and chemotherapy (p<0.05). For extended application in other cohorts, a nomogram including four factors without race was subsequently created. The consistency index (C-index) of the nomogram predicting survival was 0.736, which was well-validated in the validation cohorts (0.746 for the internal validation cohort and 0.765 for the external validation cohort). In both the training and validation cohorts, the 3-year survival rates predicted by the nomogram were comparable to the actual ones. We then succeeded in dividing patients with NECC into high- and low-risk groups concerning OS using the nomogram we developed. Besides, univariate analysis showed that chemotherapy ≥4 cycles may improve the OS of patients at YCH with NECC. Conclusion We successfully constructed a nomogram that precisely predicts the OS for patients with NECC based on the SEER database and a large single-center retrospective cohort. The visualized and practical model can distinguish high-risk patients for recurrence and death who may benefit from clinical trials of boost therapy effectively. We also found that patients who received more than 4 cycles of chemotherapy acquired survival benefits than those who received less than 4 cycles.

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A nomogram model based on neuroendocrine markers for predicting the prognosis of neuroendocrine carcinoma of cervix

Jia

Zou

et al. 2023

Preprint

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Purpose Combining traditional clinical parameters with neuroendocrine markers to construct a nomogram model to predict the postoperative recurrence of neuroendocrine carcinoma of cervix (NECC). Methods 257 patients were included in this study, of which, 171 patients diagnosed with NECC who underwent surgery at West China Second Hospital of Sichuan University were considered as part of the training cohort. The univariate and multivariate Cox regression analyses were used in screening the high-risk factors related to cancer recurrence in the training cohort to establish a nomogram model which was further independently validated in the remaining 86 patients who underwent surgery at First Affiliated Hospital of Chongqing Medical University. The calibration curve was used to conduct the internal and external verification of the model. Results Overall, 41 relapse cases were observed in the training (23 cases) and validation (18 cases) cohorts. The univariate analysis preliminarily showed that FIGO stage, stromal invasion, nerve invasion, lymph vascular space invasion, lymph node involvement, cervical-uterine junction invasion and CgA were correlated with NECC recurrence. The multivariate analysis further confirmed that FIGO stage (P = 0.023), stromal invasion (P = 0.002), lymph vascular space invasion (P = 0.039) and lymph node involvement (P = 0.00) were independent risk factors for NECC recurrence, which were ultimately included in the nomogram model. In addition, superior consistency indices were demonstrated in the training (0.863, 95%CI 0.784–0.942) and validation (0.884, 95%CI 0.758–1.010) cohorts. Conclusion The established nomogram model combining traditional clinical parameters with neuroendocrine markers can reliably and accurately predict the recurrence risks in NECC patients.

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Small cell neuroendocrine carcinoma of the cervix: Analysis of prognostic factors and patterns of metastasis

Cited by 4 publications

References 24 publications

Population-Based Survival Analysis of Stage IVB Small-Cell Neuroendocrine Carcinoma in Comparison to Major Histological Subtypes of Cervical Cancer

Population-Based Survival Analysis of Stage IVB Small-Cell Neuroendocrine Carcinoma in Comparison to Major Histological Subtypes of Cervical Cancer

Prognostic model for survival in patients with neuroendocrine carcinomas of the cervix: SEER database analysis and a single-center retrospective study

A nomogram model based on neuroendocrine markers for predicting the prognosis of neuroendocrine carcinoma of cervix

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