Surgical treatment for neuroendocrine carcinoma of the uterine cervix

ObjectiveTo identify the best operative approach for neuroendocrine cervical carcinoma (NECC).MethodsThe records of surgically treated patients with stages IB to IIB NECC were reviewed.ResultsOf 10 patients who met the study criteria for NECC and underwent radical hysterectomy, 4 had pT1bN0, 4 had pT1bN1, 1 had pT2aN0, and 1 had pT2bN1 disease. Those with pT1bN1 or pT2bN1 disease received postoperative adjuvant radiotherapy and/or chemotherapy, and recurrence occurred in 7 patients (70%). Among these 7 patients, 5 (71%) had a primary NECC tumor with deep stromal invasion and 5 (71%) had extrauterine disease (parametrium and/or lymph node). The recurrences in 6 patients (86%) were located outside the pelvis (lung, liver, or brain). Stromal invasion was 6 mm or less in the 3 patients who did not experience disease recurrence.ConclusionsPelvic control by radical hysterectomy may not be beneficial for patients with NECC except for those with an early invasive lesion.