Clinicopathologic characteristics and prognostic outcomes of surgically treated neuroendocrine cervical carcinoma: A single institution retrospective analysis.

OBJECTIVE

To investigate the clinicopathologic characteristics and prognostic outcomes of patients with neuroendocrine cervical carcinoma (NECC) who underwent surgical treatment.

METHODS

A retrospective descriptive analysis was conducted on 22 patients with histologically confirmed NECC who underwent surgery at the Cancer Hospital of Shantou University Medical College (2012-2022).

RESULTS

The median age at diagnosis was 46 years. Preoperative cervical biopsies confirmed NECC in 10 cases, while 12 cases were identified as other pathologic types. Among the nine patients who underwent ThinPrep cytologic testing (TCT), seven (77.8%) exhibited abnormalities. HPV testing revealed HPV18 positivity in seven of eight diagnostic patients and HPV16 positivity in one. Lymph node metastases were detected in seven patients through lymphadenectomy. Postoperative pathology revealed concurrent malignancies in seven patients, including cervical adenocarcinoma (3), cervical adenosquamous carcinoma (1), endometrial adenocarcinoma (2), and endometrial adenosquamous carcinoma (1). Tumors expressed synaptophysin (SYN) (18/18 cases; 100%), chromogranin (CGA) (11/12 cases; 91.7%), and CD56 (15/17; 88.2%). The 2-year recurrence-free survival (RFS) and overall survival (OS) rates were 63.6% and 68.2%, respectively; the 3-year RFS and OS rates were 61.9% and 66.7%. Univariate analysis identified FIGO stage (P < 0.001) and multiple lymph node metastases (P < 0.001) as significant prognostic factors for progression-free survival (PFS), while multiple lymph node metastases were also significantly (P = 0.001) associated with OS.

CONCLUSION

NECC is a highly aggressive subtype of cervical cancer, frequently associated with HPV infection-particularly HPV18-and characterized by a high risk of lymph node metastasis and poor prognosis. NECC often coexists with other malignancies. ThinPrep cytology test (TCT) combined with HPV testing may be a potential method for early detection. Surgical resection followed by adjuvant chemotherapy and/or radiotherapy may be an effective treatment strategy for early-stage NECC. FIGO stage and the extent of multiple lymph node metastases are key prognostic factors.