Song Xiaochen, Zhang Hui, Zhong Sen, Tan Xianjie, Ma Shuiqing, Jin Ying, Pan Lingya, Wu Ming, Cao Dongyan, Yang Jiaxin, Xiang Yang
Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, National Clinical Research Center for Obstetric & Gynecologic Diseases, Beijing, China.
Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Ann Med. 2025 Dec;57(1):2466667. doi: 10.1080/07853890.2025.2466667. Epub 2025 Mar 18.
The current treatment for early-stage neuroendocrine carcinoma of the cervix (NECC) mainly relies on operation and chemotherapy. We want to evaluate values of postoperative radiation in early-stage NECC.
Retrospective cohort study. Early-stage NECC patients from 2006 to 2022 in our hospital were included and divided into Postoperative non-radiation group (Group A) and Postoperative radiation group (Group B). We use Kaplan-Meier method to analyze the progression-free survival (PFS), overall survival (OS), recurrence and OS rate.
Sixty-six cases were included, 32 (48.5%) in Group A and 34 (51.5%) in Group B. After 35 (range 12-116) months follow-up, 26 (39.4%) had recurrence. Compared with Group A, Group B had lower pelvic recurrence rate (12.5% vs 2.9%, = 0.142), higher distant recurrence rate (28.1% vs 44.1%, = 0.177), and similar mortality rate (29.4% vs 31.3%, = 0.871). Postoperative radiation in patients with cervical stromal invasion ≥1/2 showed an extended trend in PFS (33.9 months vs 47.9 months) and OS (40.7 months vs 70.0 months) but without statistical difference ( = 0.963, = 0.636). Lymph-vascular space invasion (LVSI) is a high-risk factor for tumour recurrence (HR 9.13, = 0.005), but radiation after surgery did not improve the PFS (51.5 months vs 48.8 months, = 0.942) and OS (53.9 months vs 60.6 months, = 0.715) in patients with LVSI.
Retrospective study and relative small sample size.
Postoperative radiation seems to prolong PFS and OS in patients with cervical stromal invasion ≥1/2. LVSI was a high-risk factor for tumour recurrence, but radiation after surgery in patients with LVSI seems have no survival benefits.
宫颈早期神经内分泌癌（NECC）的当前治疗主要依靠手术和化疗。我们想要评估早期NECC术后放疗的价值。
回顾性队列研究。纳入我院2006年至2022年的早期NECC患者，并分为术后未放疗组（A组）和术后放疗组（B组）。我们采用Kaplan-Meier法分析无进展生存期（PFS）、总生存期（OS）、复发率和OS率。
共纳入66例患者，A组32例（48.5%），B组34例（51.5%）。经过35个月（范围12 - 116个月）的随访，26例（39.4%）出现复发。与A组相比，B组盆腔复发率较低（12.5%对2.9%，P = 0.142），远处复发率较高（28.1%对44.1%，P = 0.177），死亡率相似（29.4%对31.3%，P = 0.871）。宫颈间质浸润≥1/2的患者术后放疗在PFS（33.9个月对47.9个月）和OS（40.7个月对70.0个月）方面呈延长趋势，但无统计学差异（P = 0.963，P = 0.636）。脉管间隙浸润（LVSI）是肿瘤复发的高危因素（HR 9.13，P = 0.005），但LVSI患者术后放疗并未改善PFS（51.5个月对48.8个月，P = 0.942）和OS（53.9个月对60.6个月，P = 0.715）。
回顾性研究且样本量相对较小。
术后放疗似乎可延长宫颈间质浸润≥1/2患者的PFS和OS。LVSI是肿瘤复发的高危因素，但LVSI患者术后放疗似乎无生存获益。
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