Large cell neuroendocrine carcinoma of the cervix: Prognostic factors and survival advantage with platinum chemotherapy

ObjectiveLarge cell neuroendocrine carcinoma of the cervix (LCNEC) is a rare cervical neoplasm associated with poor survival. Our objective was to identify treatments associated with improved survival.MethodsRelevant data were abstracted from an English literature MEDLINE search, SEER database, and a patient treated at our institution. Multivariate analysis was performed by generating Cox proportional hazard ratios.ResultsWe identified 62 patients with LCNEC: 49 cases from the English literature, 12 patients in the SEER database and our patient. Out of the 62 women, median age was 37 (range, 21–75). FIGO stage was as follows: 58% had stage I disease, 16% had stage II, 2% had stage III, 8% had stage IV disease and 16% had no stage documented. Of all patients, 73% underwent primary surgery, 4.7% underwent primary radiation, 4.7% underwent chemotherapy, 8% had chemoradiation, and 9.6% had no primary treatment. Of all patients, 58% died of disease, 26% had no evidence of disease, 3% were alive with disease, and 13% had no survival data. The overall median survival was 16.5 months (0.5–151 months). Median overall survival for stage I, II, III, and IV cancers was 19, 17, 3, and 1.5 months, respectively. In a multivariate analysis, earlier stage (p < 0.00001) and the addition of chemotherapy (p = 0.04) were associated with improved survival. Both platinum agents (p = 0.034) and platinum and etoposide together (p = 0.027) were associated with improved survival.ConclusionsPerioperative chemotherapy, in particular platinum with or without etoposide, improves survival in the rare LCNEC.

Research highlights
► Large cell neuroendocrine carcinoma of the cervix is a rare cervical neoplasm.
► Median overall survival for stages I and IV cancers was 19 and 1.5 months, respectively.
► Platinum chemotherapy improved survival.