Abstract 20P
Background
Neuroendocrine carcinoma of the cervix (NECC) is a rare variant of cervical cancer with biologically aggressive in nature. This study aimed to report the clinicopathological characteristics, treatment patterns, survival and factors affecting survival of NECC patients treated at National Cancer Institute, Malaysia.
Methods
This is a retrospective study of NECC patients registered at our centre between 2013 and 2023. Kaplan-Meier and Cox regression methods were used for statistical analyses.
Results
A total of 32 patients were included. 62.5% patients were < 45 years old (range, 25 - 77). Most patients were multiparous (81.3%), with 90.6% presented with vaginal bleeding. 62.5% had advanced disease upon diagnosis with majority had tumour > 4 cm (65.6%) and nodal negative (53.1%). On histopathologic review, all tumours were high grade with 75% tumours were classified as small cell, 21.9% were large cell, and 3.1% was mixed small and large cell. Out of 32 histopathological specimens, 26 proceeded for immunohistochemistry profile where all were tested positive for at least a single neuroendocrine marker and 84.6% were expressed for at least 2 neuroendocrine markers. Synaptophysin was tested positive in 95.8%, chromogranin in 79.2% and CD56 in 100% of tumours. In term of treatments, 53.1% and 21.9% received surgical based primary treatment and radiotherapy based primary treatment respectively. The most used chemotherapy regime as neoadjuvant, adjuvant or first-line palliative chemotherapy were Etoposide/platinum (n = 14) and Paclitaxel/carboplatin (n = 1). Folinic acid/fluorouracil/oxaliplatin (n = 1) and single agent irinotecan (n = 2) were also reported in subsequent line of palliative setting. After a median follow-up of 10.8 months (range, 0.8 - 98.9), the median overall survival for early stage and advanced stage were 30.2 and 8.0 months respectively. The 1-year and 2-year survival rates were 75% and 25% respectively for early stage, while 20% and 5% respectively for advanced stage. On multivariate analysis, advanced stage at diagnosis was predictive of poor survival.
Conclusions
NECC is a rare variant of cervical cancer that present in the advanced stage and portend poor prognosis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.