Introduction/Background Neuroendocrine cervical cancer is a rare subtype of cervical cancer which account for 1.0–1.5% of all type of cervical cancer. Neuroendocrine cervical cancer is more likely to metastasize to lymph nodes and invade to lymph vascular space at the time of diagnosis resulting in higher rate of recurrence and worse 5-year survival rate. Due to the rarity of the tumor, it has been understudied. There is an unmet need for developing clinical markers for predicting prognosis of this particular type of tumor.Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) can yield quantitatively calculated parameters. There are some reports showing predictive value of these parameters in squamous cell carcinoma or adenocarcinoma of cervix. However, studies to identify the association between FDG-PET/CT parameters and prognosis of neuroendocrine cervical cancer is still lacking.

Methodology This retrospective study includes 29 neuroendocrine cervical cancer patients treated at Asan medical center, Seoul, Korea from 2007 to 2021. All patients underwent whole-body FDG-PET/CT before initial treatment. The following parameters were measured and recorded: SUVmax, SUVpeak, MTV2.5, MTV3.0, TLG2.5 and TLG3.0. The association between these parameters and disease free survival and overall survival were analyzed using univariate and mutivariate Cox proportional hazards model.

Results Median age of patient was 45 years, ranging from 29 to 70. Median follow up period was 40 month raging from 4 to 184. Median disease free survival (DFS) time was 17 month and median overall survival (OS) time was 40 month.For DFS, univariate anaylsis showed that age, TLG2.5 and 3.0 were statistically significant. Whereas, multivariate analysis showed that only age and TLG3.0 were the independent prognostic variables. Univariate and multivariate analysis showed that none of the parameters were associated with OS.

Conclusion Among the parameters of FDG PET/CT, TLG 3.0 was the independent prognostic factor for DFS and maybe associated with overall survival.