Introduction/Background We investigate prognostic factors and impact of the minimally invasive surgery (MIS) in surgically treated early-stage high-grade (HG) neuroendocrine cervical carcinoma (NECC).
Methodology Between 1993 and 2017, 47 patients with FIGO (2009) stage IA-IIA HG NECC were initially treated with radical hysterectomy. Clinicopathological variables of the patients were retrospectively reviewed from electronic medical records. Cox proportional hazards regression was used to identify potential prognostic factors. According to surgical approach, survival curves were compared using the Kaplan-Meier method with log rank test.
Results The median follow-up period was 28.2 months (range, 3.83–202.5). Stage IB1 disease was the most common (70.2%). Twenty-nine patients (61.7%) underwent RH via MIS. The overall survival (OS) rate was 63.8.0%, and the disease-free survival (DFS) rate was 38.3%. Lymph-node (LN) metastasis was an independent significant risk factor for OS (HR, 2.594; 95% CI, 1.152–5.842; P=0.021) and DFS (HR, 3.236; 95% CI, 1.188–8.815; P=0.022). The Kaplan-Meier survival curves revealed that there was no significant difference in OS and DFS between the laparotomy group and MIS group (50% vs. 72.4% log-rank p value=0.196, 38.9% vs. 37.9% p=0.975). Moreover, the type of surgical approach was not a risk factor for OS (HR, 0.467; 95% CI, 0.714–1.257; P=0.132) and DFS (HR, 1.048; 95% CI, 0.494–2.224; P=0.093).
Conclusion LN metastasis was a poor prognostic factor of survival outcomes in initially surgically treated early-stage HG NECC. There was no difference in survival between the MIS and laparotomy approached.
Disclosure Nothing to disclose.
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