Clinical outcomes of neuroendocrine carcinoma of the cervix: Retrospective review from a large academic cancer centre

Neuroendocrine cervical carcinomas are a rare but aggressive malignancy associated with a poor prognosis and there is limited evidence to guide clinical decision-making. Our objective was to evaluate the patterns of practice and clinical outcomes of patients diagnosed with neuroendocrine cervical carcinoma. This was a retrospective chart review of patients diagnosed with neuroendocrine cervical carcinoma between 2007 and 2023. Demographic, treatment, and outcome data were extracted from the medical records and summarized using descriptive statistics. In total 32 patients were identified. Median follow-up was 14.5 months, and median age at diagnosis was 52 (range 21-89), 31.3 % (10/32) were stage IVB at time of diagnosis. Primary treatment consisted of surgery in 10 patients (31.3 %) and chemo-radiation in 15 patients (46.9 %), with the remainder of patients (7/32, 21.9 %) receiving upfront palliative therapy. Adjuvant chemotherapy typically consisted of a combination of cisplatin and etoposide. Median OS for the full cohort was 19 months (2-year OS 39 %, 2-year LR 9 %, 2-year LRR 9 %). Primary surgery was generally offered to patients with earlier stage disease (IA2-IIA1) relative to primary chemoradiotherapy (IB1-IVB). Patients treated with primary surgery had significantly higher median OS compared to those treated with primary chemoradiotherapy (39 vs 19 months, p = 0.04). Treatment failure usually consistent of distant metastatic relapse (15/20, 75 %). In our single institution review of neuroendocrine carcinoma of the cervix, primary surgery was associated with improved OS; however, our sample size was small with a bias to offering upfront surgery to patients with earlier stage disease.