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Clinicopathological Analysis of Neuroendocrine Carcinoma of the Uterine Cervix: A Single-Institution Retrospective Review of 9 Cases

Aim. To evaluate the clinicopathological features affecting the recurrence and survival of 9 cases of neuroendocrine cancer of the cervix. Method. We retrospectively analyzed 9 cervical neuroendocrine cancer cases identified among 453 cervical cancer patients between 2004 and 2021 at Akdeniz University Gynecological Oncology Outpatient Clinic. Kaplan–Meier survival analysis was used for progression-free survival (PFS) and overall survival (OS). Mathematical functions of mean, standard deviation, median, Min–Max values, and frequencies were used for descriptive statistics. The categorical data were expressed in numbers and percentages (%). Results. Nine patients with neuroendocrine histological subtype were selected out of 453 patients diagnosed with cervical cancer (1.98%). The average overall survival time of the patients was 26 months. The 5-year survival rate was 53.3%, while the PFS was 62.5%. The most common subtype was small cell neuroendocrine cancer. Tumours were mostly locally advanced at the time of diagnosis. 3 patients’ stage was 1b2, while 4 patients were 2b, 1 patient was 3c2r, and 1 patient was 4b. All tumours showed the immunohistochemical staining properties of neuroendocrine cancer. The main treatment modality applied to our patients was surgery + adjuvant CRT. The most used chemotherapeutic agents were cisplatin/carboplatin and etoposide. Recurrence was found in 3 cases, including 5 deaths. Conclusion. Neuroendocrine tumour of the cervix is a rare subtype with a poor prognosis. Unfortunately, there is not yet a standard treatment protocol due to the limited number of comparative studies of surgery, chemotherapy, and radiotherapy based treatment schemes.

Comparative Oncologic Outcomes in High-Risk Human Papillomavirus-Positive and -Negative Cervical Intraepithelial Neoplasia

BACKGROUND The clinical significance of high-risk human papillomavirus (HR-HPV)-negative high-grade cervical intraepithelial neoplasia remains unclear. A negative HR-HPV test result can stem from assay limitations (e.g., low viral load, non-covered types) or biological factors (e.g., viral clearance, true HPV-independent pathways). This study aimed to compare recurrence and hysterectomy rates between HR-HPV-positive and HR-HPV-negative women in a cohort of 712 women who underwent cervical conization for cervical intraepithelial neoplasia grade 3 (CIN3). MATERIAL AND METHODS This retrospective, multicenter cohort study analyzed data from 712 women with a histopathological diagnosis of CIN3 between 2014 and 2023. HR-HPV detection and genotyping were performed using the Cobas 4800 (Roche HPV assay) test. A review of patient records was conducted, and statistical analyses included Kaplan-Meier survival estimates and Cox proportional hazards regression models. RESULTS In our cohort of 712 women with CIN3, 9% (n=64) were HR-HPV-negative. The primary finding was that HR-HPV-negative status showed no significant association with the risks of recurrence, progression to cancer, or hysterectomy compared to HR-HPV-positive cases. Specifically, recurrence rates (6.2% vs 12.1%) and the incidence of cervical cancer (2% vs 1.5%) were comparable, with no statistically significant differences (p>0.05 for both). CONCLUSIONS HR-HPV-negative CIN3 is a clinically significant entity that requires management and follow-up equivalent to HR-HPV-positive CIN3, as it demonstrates comparable oncologic outcome.