Fernandes Jason, Hodgson Anjelica, Han Kathy, Milosevic Michael, Lukovic Jelena, Lheureux Stephanie, Ferguson Sarah E, Santiago Anna, Croke Jennifer
Princess Margaret Cancer Centre, University Health Network, Toronto, ON, Canada.
Department of Radiation Oncology, University of Toronto, ON, Canada.
Gynecol Oncol Rep. 2025 Aug 20;61:101933. doi: 10.1016/j.gore.2025.101933. eCollection 2025 Oct.
Neuroendocrine cervical carcinomas are a rare but aggressive malignancy associated with a poor prognosis and there is limited evidence to guide clinical decision-making. Our objective was to evaluate the patterns of practice and clinical outcomes of patients diagnosed with neuroendocrine cervical carcinoma.
This was a retrospective chart review of patients diagnosed with neuroendocrine cervical carcinoma between 2007 and 2023. Demographic, treatment, and outcome data were extracted from the medical records and summarized using descriptive statistics.
In total 32 patients were identified. Median follow-up was 14.5 months, and median age at diagnosis was 52 (range 21-89), 31.3 % (10/32) were stage IVB at time of diagnosis. Primary treatment consisted of surgery in 10 patients (31.3 %) and chemo-radiation in 15 patients (46.9 %), with the remainder of patients (7/32, 21.9 %) receiving upfront palliative therapy. Adjuvant chemotherapy typically consisted of a combination of cisplatin and etoposide. Median OS for the full cohort was 19 months (2-year OS 39 %, 2-year LR 9 %, 2-year LRR 9 %). Primary surgery was generally offered to patients with earlier stage disease (IA2-IIA1) relative to primary chemoradiotherapy (IB1-IVB). Patients treated with primary surgery had significantly higher median OS compared to those treated with primary chemoradiotherapy (39 vs 19 months, p = 0.04). Treatment failure usually consistent of distant metastatic relapse (15/20, 75 %).
In our single institution review of neuroendocrine carcinoma of the cervix, primary surgery was associated with improved OS; however, our sample size was small with a bias to offering upfront surgery to patients with earlier stage disease.
神经内分泌宫颈癌是一种罕见但侵袭性强的恶性肿瘤，预后较差，指导临床决策的证据有限。我们的目的是评估诊断为神经内分泌宫颈癌患者的治疗模式和临床结局。
这是一项对2007年至2023年间诊断为神经内分泌宫颈癌患者的回顾性病历审查。从医疗记录中提取人口统计学、治疗和结局数据，并使用描述性统计进行总结。
共确定了32例患者。中位随访时间为14.5个月，诊断时的中位年龄为52岁（范围21 - 89岁），31.3%（10/32）在诊断时为IVB期。主要治疗包括10例患者（31.3%）接受手术，15例患者（46.9%）接受放化疗，其余患者（7/32，21.9%）接受初始姑息治疗。辅助化疗通常由顺铂和依托泊苷联合组成。整个队列的中位总生存期为19个月（2年总生存率39%，2年局部复发率9%，2年局部区域复发率9%）。相对于主要放化疗（IB1 - IVB期），主要手术通常提供给疾病分期较早（IA2 - IIA1期）的患者。接受主要手术治疗的患者中位总生存期显著高于接受主要放化疗的患者（39个月对19个月，p = 0.04）。治疗失败通常表现为远处转移复发（15/20，75%）。
在我们对宫颈神经内分泌癌的单机构回顾中，主要手术与总生存期改善相关；然而，我们的样本量较小，且倾向于为疾病分期较早的患者提供初始手术。
