799P - Clinicopathological characteristics and oncological outcomes of three subtypes of neuroendocrine carcinoma of the cervix: A multicenter retrospective study of 288 patients

Background

Neuroendocrine carcinoma of the cervix (NECC) is a rare type of cervical cancer, and is divided into small cell neuroendocrine carcinoma (SCNEC), large cell neuroendocrine carcinoma (LCNEC) and mixed neuroendocrine-non-neuroendocrine neoplasm (MiNEN). Present studies on NECC mainly focus on SCNEC, and the clinical features of LCNEC, especially MiNEN, are not well understood.

Methods

The 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.

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%; and the 5-year OS was 45.4%, 44.0%, 32.3%, and 50.3%. In the whole cohort, it showed that LVSI (HR=1.996, 95%CI:1.275∼3.126, p=0.003) 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. In patients undertaking surgery, it revealed that LVSI (HR=1.996, 95%CI:1.275∼3.126, p=0.003) and NACT (HR=1.691, 95%CI: 1.040∼2.748, p=0.034) were independent risk factors, and that adjuvant chemoradiotherapy was an independent protective factor of PFS (HR=0.201, 95%CI: 0.103∼0.428, p<0.001); age>42 (HR=2.377, 95%CI: 1.417∼3.986, p=0.001) and LVSI (HR=2.450, 95%CI: 1.388∼4.324, p=0.002) were independent risk factors of OS, and that adjuvant chemoradiotherapy was an independent protective factor of OS (HR=0.175, 95%CI: 0.079∼0.388, p<0.001).

Conclusions

This multicenter retrospective study first focused on three pathological subtypes of NECC. SCNEC has a worse biological behavior than the other two types. Patients with MiNEN did not show better prognosis than the other two. 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.

Clinical trial identification

Editorial acknowledgement

Legal entity responsible for the study

The authors.

Funding

The study was supported by the National Natural Science Foundation of China (No.82001664), and the Capital’s Funds for Health Improvement and Research (CFH 2022-1-4011), and the National High Level Hospital Clinical Research Funding (2022-PUMCH-B-083 and 2022-PUMCH-B-084).

Disclosure

All authors have declared no conflicts of interest.