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  • Impact of pelvic radiation therapy in patients with early neuroendocrine cervical carcinoma and no residual disease in the radical hysterectomy specimen: a NeCTuR study

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Original research
Impact of pelvic radiation therapy in patients with early neuroendocrine cervical carcinoma and no residual disease in the radical hysterectomy specimen: a NeCTuR study
  1. Nilsha Khurana1,
  2. Michael Frumovitz2,
  3. Alejandra Flores Legarreta2,
  4. Preetha Ramalingam3,
  5. Anuja Jhingran4,
  6. Priya Bhosale5,
  7. Reem Saab2,
  8. Naomi R R Gonzales2,
  9. Gary B Chisholm2 and
  10. Gloria Salvo2
  1. 1 Neurology, Touro University, New York, New York, USA
  2. 2 Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  3. 3 Pathology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  4. 4 Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  5. 5 Department of Abdominal Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to Dr Gloria Salvo, Gynecologic Oncology and Reproductive Medicine, The University of Texas MD Anderson Cancer Center, Houston 77030, Texas, USA; gsalvo{at}mdanderson.org

Abstract

Objective The impact of adjuvant pelvic radiation therapy on the rate and location of recurrences was evaluated in patients with early-stage (IA1–IB2) neuroendocrine cervical carcinoma who underwent prior conization or polypectomy with no residual disease and negative nodes in the subsequent upfront radical hysterectomy specimen. As a secondary objective, disease-free and overall survival were analyzed.

Methods We searched the Neuroendocrine Cervical Tumor Registry (NeCTuR) to identify patients with clinical early-stage neuroendocrine cervical carcinoma with no residual disease in the specimen from upfront radical surgery and negative nodes. Patients who received pelvic radiation therapy were compared with those who did not, regardless of whether they received adjuvant chemotherapy.

Results Twenty-seven patients met the inclusion criteria, representing 17% of all patients with clinical early-stage disease who underwent upfront radical hysterectomy included in the NeCTuR registry. The median age was 36.0 years (range 26.0–51.0). Six (22%) patients had stage IA, 20 (74%) had stage IB1, and one (4%) had stage IB2 disease. Seven (26%) patients received adjuvant radiation therapy and 20 (74%) did not. All seven patients in the radiation group and 14 (70%) in the no-radiation group received adjuvant chemotherapy (p=0.16). Fifteen percent (4/27) of patients had a recurrence, 14% (1/7) in the radiation group and 15% (3/20) in the no-radiation group (p=0.99). In the radiation group the recurrence was outside the pelvis, and in the no-radiation group, 67% (2/3) recurred outside the pelvis and 33% (1/3) recurred both inside and outside the pelvis (p=0.99). In the radiation group the 5-year disease-free and overall survival rates were 100% while, in the no-radiation group, the 5-year disease-free and overall survival rates were 81% (95% CI 61% to 100%) (p=0.99) and 80% (95% CI 58% to 100%) (p=0.95), respectively.

Conclusions For patients with no residual disease and negative nodes in the upfront radical hysterectomy specimen, our study did not find that pelvic radiation therapy improves survival.

  • Cervical Cancer
  • Radiotherapy
  • Neuroendocrine Tumors

Data availability statement

In accordance with the journal’s guidelines, we will provide our data for independent analysis by a selected team by the Editorial Team for the purposes of additional data analysis or for the reproducibility of this study in other centers if such is requested.

https://doi.org/10.1136/ijgc-2023-005053

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    Data availability statement

    In accordance with the journal’s guidelines, we will provide our data for independent analysis by a selected team by the Editorial Team for the purposes of additional data analysis or for the reproducibility of this study in other centers if such is requested.

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    Footnotes

    • Twitter @frumovitz, @ajhingra@mdanderson.org

    • Contributors GS, NK, and MF: idea. NK and GS: manuscript conceptualization and writing. GS and MF: critical revision and editing. GBC: statistics. NRRG, AFL, RS, PB, AJ, and PR: revision and editing of drafts and final version of the manuscript. All authors have given final approval of this version, and all authors accept responsibility for its contents. GS and MF are responsible for the overall content as guarantors.

    • Funding This study was supported by the National Cancer Institute under award number P30CA016672, which supports the MD Anderson Cancer Center Clinical Trials Office, and Small/Large Cell Carcinoma of the Cervix: Sisters United.

    • Competing interests MF has research support from AkesoBio and is a speaker/consultant for Stryker. The other authors have no competing interests.

    • Provenance and peer review Not commissioned; externally peer reviewed.