Hou WH, et al. - Researchers intended to evaluate treatment and other factors impacting survival in cervical high-grade neuroendocrine carcinoma (HGNEC). The prognosis was poor among patients with cervical HGNECs. Primary treatment by radical surgery or external beam radiotherapy with or without brachytherapy yielded equally poor survival.

Methods

• Patients with cervical HGNECs who were diagnosed during 1988 to 2012 in the Surveillance Epidemiology and End Results database were identified.
• Using Kaplan-Meier analysis with the log-rank test, researchers determined the overall survival by International Federation of Gynecology and Obstetrics stages and by local treatment modalities, ie, radical surgery vs external beam radiation treatment (EBRT) plus brachytherapy.
• Furthermore, they determined factors of age, stage, and treatment modality impacting survival using proportional hazard analysis.

Results

• A total of 832 cases of cervical HGNECs were identified from the database.
• The International Federation of Gynecology and Obstetrics stages I to IV distributions were 196 (28.0%), 69 (9.9%), 175 (25.0%), and 260 patients (37.1%), respectively, after excluding cases with incomplete stage data.
• Similar 5-year overall survival were noted with radical surgery and primary radiotherapy for stages I (61% vs 53%, P=0.27), II (48% vs 28%, P=0.308), and III (33% vs 28%, P=0.408) patients.
• Compared to EBRT alone, external beam radiation treatment plus brachytherapy did not yield superior survival in stage I (48% vs 49%, P=0.799), II (37% vs 20%, P = 0.112), or III (25% vs 32%, P=0.636) patients.
• Independent factors influencing survival were age (P=0.004) and stage (stage II: hazard ratio [HR], 1.78, P=0.013; stage III: HR, 2.42; P<0.001).
• However, local treatment modality was not affected (EBRT: HR, 1.30, P=0.17; EBRT plus brachytherapy: HR, 1.16; P=0.417).