Preferred method of therapy for patients with early-stage high-grade neuroendocrine carcinoma of the cervix

• Published in: American journal of cancer research 2021-01, Vol.11 (9), p.4595-4606
• Main Authors: Zhang, Yuanyuan, Li, Lin, Wang, Ziyi, Huang, Yi, Luo, Suiyu, Peng, Yongmei, Li, Ning, He, Yang, Li, Chunmei, Zhang, Keqiang, Yang, Hongying, Zhou, Qi, Wu, Lingying
• Format: Article
• Language: English
• Subjects: Original
• ISSN: 2156-6976; 2156-6976

High-grade neuroendocrine carcinoma of the uterine cervix (HGNECC) is a rare and overly aggressive malignancy. Due to its rarity, there is no standard treatment. A majority of early-stage patients receive radical hysterectomy and lymph node dissection (RH+LND), followed by adjuvant chemotherapy. To explore the most suitable methods of therapy, a multicenter retrospective review of HGNECC patients was conducted. A total of 133 patients (I-IIA, FIGO 2009) treated from March 2003 to September 2018 were enrolled in this study. The 5-year DFS and OS rates for stages IB and IIA were 44.8% and 39.5%, and 53.8% and 39.6%, respectively. The median DFS and OS for stages IB and IIA were 41 months and 12 months, and 63 months and 45 months, respectively. The RH+LND surgery procedure was associated with a significantly better DFS ( P =0.015) and OS ( P =0.006), while the bilateral salpingo-oophorectomy (BSOE) was also associated with a better OS ( P =0.023). The efficacy of paclitaxel-platinum (TP/C) adjuvant chemotherapy regimens need to be confirmed using clinical trials, especially for tumors with a diameter of >4 cm ( P =0.0005). Therefore, the RH+LND+BSOE procedure was recommended for HGNECC patients at stages IB-IIA. TP/C is an alternative chemotherapy regimen that results in optimal survival. Moreover, a tumor diameter of >4 cm, LNM, DSI, and LVSI were confirmed as high-risk factors for worse DFS and OS. Patients without risk factor, 1 or 2 or 3 risk factors, and 4 risk factors had significantly different DFS and OS values.