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PR010/#135  Clinicopathological characteristics and oncological outcomes of three subtypes of neuroendocrine carcinoma of the cervix: a multicenter retrospective study of 288 patients in China
  1. Yu Gu and
  2. Yang Xiang
  1. Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Department of Obstetrics and Gynecology, Beijing, China


Introduction Neuroendocrine carcinoma of the cervix (NECC) is a rare pathological classification of cervical cancer, and is divided into small cell neuroendocrine carcinoma (SCNEC), large cell neuroendocrine carcinoma (LCNEC) and mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN).

Methods This multicenter, retrospective study enrolled 288 patients. The primary outcomes were progression-free survival (PFS) and overall survival (OS). The Kaplan-Meier method and Cox proportional hazard analysis were performed to determine risk factors of PFS and OS.

Results With a median follow up of 25 months, the 5-year PFS of NECC, SCNEC, LCNEC and MiNEN was 40.2%, 40.4%, 30.3%, and 41.6%, respectively; and the 5-year OS was 45.4%, 44.0%, 32.3%, and 50.3%, respectively. In the whole cohort, it showed that LVSI (HR=1.996, 95%CI:1.275~3.126, p=0.003), NACT (HR=1.691, 95%CI: 1.040~2.748, p=0.034), and >2/3 stromal invasion (HR=2.009, 95%CI:1.222~3.303, p=0.006) were independent risk factors of PFS; age>45 (HR=1.956, 95%CI: 1.170~3.272, p=0.011), LVSI (HR=1.722, 95%CI: 1.016~2.918, p=0.043) and >2/3 stromal invasion (HR=1.778, 95%CI: 1.024~3.087, p=0.041) were independent risk factors for OS and that adjuvant chemoradiotherapy was an independent protective factor of OS (HR=0.175, 95%CI: 0.079~0.388, p<0.001).

Conclusion/Implications This multicenter retrospective study first focused on three pathological subtypes of NECC including SCNEC, LCNEC and MiNEN. SCNEC has a worse biological behavior than the other two types. Patients with MiNEN did not have better prognosis compared to patients with SCNEC and LCNEC at the same stage. LVSI and >2/3 stromal invasion and adjuvant chemoradiotherapy are prognostic factors for PFS; age, LVSI, and >2/3 stromal invasion and adjuvant chemoradiotherapy are prognostic factors for OS in patients with NECC.

Abstract PR010/#135 Figure 1

The flow diagram of the study. Center1: Shengiing hospital of China medical university, Center2: Sichuan province Cancer Hospital; Center3: Peking union medical college hospital; SCNEC: small cell neuroendocrine carcinoma; LCNEC: large cell neuroendocrine carcinoma; MiNEN: mixed neuroendocrine-non-neuroendocrine neoplasm; NED: no evidence of disease; AWD: alive with disease

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