ArticleEuropean journal of obstetrics & gynecology and reproductive biology: X2025
Neuroendocrine carcinoma of the cervix (NECC): A retrospective study of 175 Chinese patients.
Article in European journal of obstetrics & gynecology and reproductive biology: X, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Neuroendocrine carcinoma of the cervix (NECC) is rare and aggressive. We analyzed a dual-center Chinese cohort to describe clinicopathologic features, outcomes, and treatment patterns, and to identify prognostic factors. Methods: We retrospectively included patients with pathologically confirmed NECC treated from June 2012 to June 2021. Variables included age at diagnosis, symptoms, high-risk human papillomavirus (hrHPV), FIGO 2009/2018 stage, tumor histology, tumor diameter, depth of stromal invasion (DOI), lymphovascular space invasion (LVSI), lymph-node metastasis (LNM), and treatments. Follow-up followed NCCN guidance. Survival was assessed using Kaplan-Meier and Cox regression. Results: We analyzed 175 patients. hrHPV was positive in 54.3 % (95/175); 84.0 % (147/175) presented with abnormal vaginal bleeding. By FIGO 2018, 39.4 % (69/175) had stage IIB-IVB disease. On univariable Cox regression analysis, younger age, higher FIGO stage (2009 and 2018), pure NECC histology, deeper DOI, larger tumor diameter, and positive LNM were associated with worse survival. In contrast, multivariable Cox regression analysis revealed that FIGO 2009 stage and DOI were independent predictors of both progression-free survival (PFS) and overall survival (OS); tumor histology was independently associated with OS. Survival did not differ between abdominal and laparoscopic radical hysterectomy. Among surgically treated patients, adjuvant radiotherapy did not improve PFS or OS across early-stage, locally advanced, or late-stage subgroups. Conclusions: In this cohort, primary-tumor factors-especially DOI-and FIGO 2009 stage were independent prognostic factors, whereas surgical route and postoperative radiotherapy showed no survival benefit; these findings can inform staging considerations and treatment decisions for NECC.
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