Cervical neuroendocrine carcinoma with non-neuroendocrine components has a poorer prognosis than pure neuroendocrine carcinoma

초록

Objective: To investigate whether neuroendocrine carcinoma of the cervix (NECC)with coexisting non-neuroendocrine tumor components (mixed subtype) is associatedwith a worse prognosis compared to the pure subtype. Methods: A total of 121 patients diagnosed with NECC at 4 participating hospitals in theRepublic of Korea between August 1997 and November 2023 were included. All diagnoseswere confirmed through surgical specimens obtained via conization or hysterectomy. Clinicaland pathological variables were collected through medical record review. The associationbetween tumor heterogeneity (pure vs. mixed subtype) and progression-free survival (PFS)was analyzed using a Cox proportional hazards model. Results: The majority of patients was diagnosed at stage I (62%), had small cell histology(63%), and presented with the pure subtype (66%). Most patients (n=106) underwentsurgery with or without adjuvant therapy as initial treatment. In univariate analysis, therewas no significant difference in PFS between the pure and mixed subtypes (p=0.952). However, after adjusting for covariates, the mixed subtype was significantly associatedwith worse PFS compared to the pure subtype (adjusted hazard ratio=3.16; 95% confidenceinterval=1.58–6.35; p=0.001). Conclusion: NECC with non-neuroendocrine components is associated with significantlyworse prognosis than the pure subtype.

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