Neuroendocrine Carcinoma Of Uterine Cervix: Preliminary Observation On Its Response To Chemotherapy And The Prognostic Factors

Objective：To analyze the clinicopathologic characteristics, responseto chemotherapy and prognosis in patients with neuroendocrine carcinomaof uterine cervix (NECC), investigating the value of primary chemotherapyin this disease.Methods: We performed a retrospective analysis about theclinicopathologic and follow-up data of17patients with NECC who weretreated in our hospital between1/2011and1/2014. Through comparing theinitial tumor size with the postoperative specimen as well as pathologicalresult, we evaluated the response to primary chemotherapy in the15patients who received following operation. In addition, we analyzed therecurrence and survival of these patients to investigate the prognosticfactors.Results：Median age of the17NECC patients was44years old(ranging from31to69), with early stage in6cases and late stage in11cases. Two patients chose concurrent chemoradiotherapy, and the other15 underwent surgery followed by adjuvant chemo-or radio-therapy afterneoadjuvant chemotherapy. Among the15patients,9(60%) were pure and6(40%) were mixed histology. All tissue samples had at least oneneuroendocrine markers positive, with deep myometrial invasion in3,lymph node metastasis in3and lymph-vascular space involvement in2.After neoadjuvant chemotherapy,80.0%(12/15) obtained clinical response,with pathological complete and partial response as20.0%(3/15) and60%(9/15), respectively.3patients had stable disease and with no progressivedisease. Six patients recurred during our follow-up period. Kaplan-Meierunivariate survival analysis showed that patients’ age, disease stage,tumor’s homology or size, cycle of chemotherapy had no significantcorrelation to recurrence and survival. In contrast, lymph node involvement,deep myometrial invasion and patients’ response to neoadjuvantchemotherapy might be the prognostic factors.Conclusions： NECC is a rare but aggressive type of cervicalcarcinoma. It has poorer prognosis compared with other types of cervicalmalignancies. Lymph node metastasis, deep myometrial invasion and poorresponse to chemotherapy might affect patients’ prognosis and survival.The combination of chemotherapy, radiotherapy and surgery mightimprove the prognosis in patients with NECC.