High-Grade Neuroendocrine Carcinoma of the Cervix

Baykal, Cem; Al, Armstrong; Tulunay, Gökhan; Bulbul, Dilek; Güler, Gülnur; Özer, Songül Peltek; Küçükali, T.

doi:10.1159/000084259

Cited by 9 publications

(5 citation statements)

References 61 publications

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“…The exact dosage and therapy duration of this scheme, however, varied considerably in the published studies. For example, Baykal et al used cisplatin 80 mg/m 2 on day 1 together with etoposide 120 mg/m 2 on days 1, 2, and 3 in a 21 day cycle [ 26 ]. Intaraphet et al used cisplatin 75 mg/m 2 and etoposide 100 mg/m 2 every 3 weeks [ 59 ].…”

Section: Discussionmentioning

confidence: 99%

Neuroendocrine carcinoma of the cervix: a systematic review of the literature

et al. 2018

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BackgroundNeuroendocrine carcinoma of the cervix (NECC) is a rare variant of cervical cancer. The prognosis of women with NECC is poor and there is no standardized therapy for this type of malignancy based on controlled trials.MethodsWe performed a systematic literature search of the databases PubMed and Cochrane Central Register of Controlled Trials to identify clinical trials describing the management and outcome of women with NECC.ResultsThree thousand five hundred thirty-eight cases of NECC in 112 studies were identified. The pooled proportion of NECC among women with cervical cancer was 2303/163470 (1.41%). Small cell NECC, large cell NECC, and other histological subtypes were identified in 80.4, 12.0, and 7.6% of cases, respectively. Early and late stage disease presentation were evenly distributed with 1463 (50.6%) and 1428 (49.4%) cases, respectively. Tumors expressed synaptophysin (424/538 cases; 79%), neuron-specific enolase (196/285 cases; 69%), chromogranin (323/486 cases; 66%), and CD56 (162/267; 61%). The most common primary treatment was radical surgery combined with chemotherapy either as neoadjuvant or adjuvant chemotherapy, described in 42/48 studies. Radiotherapy-based primary treatment schemes in the form of radiotherapy, radiochemotherapy, or radiotherapy with concomitant or followed by chemotherapy were also commonly used (15/48 studies). There is no standard chemotherapy regimen for NECC, but cisplatin/carboplatin and etoposide (EP) was the most commonly used treatment scheme (24/40 studies). Overall, the prognosis of women with NECC was poor with a mean recurrence-free survival of 16 months and a mean overall survival of 40 months. Immune checkpoint inhibitors and targeted agents were reported as being active in three case reports.ConclusionNECC is a rare variant of cervical cancer with a poor prognosis. Multimodality treatment with radical surgery and neoadjuvant/adjuvant chemotherapy with cisplatin and etoposide with or without radiotherapy is the mainstay of treatment for early stage disease while chemotherapy with cisplatin and etoposide or topotecan, paclitaxel, and bevacizumab is appropriate for women with locally advanced or recurrent NECC. Immune checkpoint inhibitors may be beneficial, but controlled evidence for their efficacy is lacking.Electronic supplementary materialThe online version of this article (10.1186/s12885-018-4447-x) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Neuroendocrine carcinoma of the cervix: a systematic review of the literature

et al. 2018

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“…Although the incidence of this kind of tumor is low, it is prone to lymphatic and hematogenous metastasis in the early stage, and its prognosis is significantly worse than that of cervical squamous cell carcinoma and adenocarcinoma in the same period [30]. e prognostic factors for NEC patients have not yet been determined, but most studies indicated that the main factors affecting the prognosis of NEC patients include clinical stage, tumor size, lymph node metastasis, and the efficacy of treatment; thus, the early and precise diagnosis of cervical NEC is quite significant to improve the prognosis [31]. However, the rate of misdiagnosis for NEC is considerably high even for specialist pathologists [31], raising the question whether a computer-assisted pathological diagnosis may be helpful to improve the accuracy of diagnosis [31].…”

Section: Neuroendocrinementioning

confidence: 99%

“…e prognostic factors for NEC patients have not yet been determined, but most studies indicated that the main factors affecting the prognosis of NEC patients include clinical stage, tumor size, lymph node metastasis, and the efficacy of treatment; thus, the early and precise diagnosis of cervical NEC is quite significant to improve the prognosis [31]. However, the rate of misdiagnosis for NEC is considerably high even for specialist pathologists [31], raising the question whether a computer-assisted pathological diagnosis may be helpful to improve the accuracy of diagnosis [31]. Nevertheless, the automatic detection of NEC lesions by computer on WSI is quite challenging due to the extremely small amount of data and the unavailability of precisely labeled data due to the low prevalence of the tumor and the huge labor consumption of manual annotation.…”

Section: Neuroendocrinementioning

confidence: 99%

NECScanNet: Novel Method for Cervical Neuroendocrine Cancer Screening from Whole Slide Images

Liao

Qin

Zheng

2021

Security and Communication Networks

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As a rare malignant tumor, cervical neuroendocrine cancer (NEC) is difficult in diagnosis even for experienced pathologists. A computer-assisted diagnosis may be helpful for the improvement of diagnostic accuracy. Nevertheless, the computer-aided pathological diagnosis has to face a great challenge that the hundred-million-pixels or even gig-pixels whole slide images (WSIs) cannot be applied directly in the existing deep convolution network for training and analysis. Therefore, the construction of a neural network to realize the automatic screening of cervical NEC is challenging; meanwhile, as far as we know, little attention has been paid to this field. In order to address this problem, here we present a multiple-instance learning method for automatic recognition of cervical NEC on pathological WSI, which consists of the Sliding Detector module and Lesion Analyzer module. A pathological WSI dataset, which is composed of 84 NEC cases and 216 NEC-free cases from the Pathological Department of West China Second University Hospital, is applied to evaluate the performance of the method. The experimental results show that the recall rate, accuracy rate, and precision rate of our method for automatic recognition are 92.9%, 92.7%, and 83.0%, respectively, demonstrating the effectiveness and the potential in clinical practice. The application of this method in computer-assisted pathological diagnosis is expected to decrease the misdiagnosis as well as the false diagnosis of rare cervical NEC, and, consequently, improve the therapeutic effect of cervical cancers.

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“…However, SCNEC is an aggressive type of cancer that develops distant metastases even in its early stages [4,5]. Lymph node involvement and lymph vascular space invasion are thus present relatively early on in the progression of SCNEC and are related to early relapse due to hematogenous dissemination [6,7].…”

Section: Introductionmentioning

confidence: 99%

A Multicenter Study of the Importance of Systemic Chemotherapy for Patients with Small-Cell Neuroendocrine Carcinoma of the Uterine Cervix

Lee¹,

Lim

Bae

et al. 2014

Gynecol Obstet Invest

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Aims: We investigated the prognosis of patients with small-cell neuroendocrine carcinoma of the uterine cervix (SCNEC) in relation to treatment modalities. Methods: We retrospectively reviewed the medical records and pathological reports of 102 patients who were histologically diagnosed with SCNEC at 5 different institutes. Time to progression (TTP) and overall survival (OS) were analyzed for each treatment modality. Results: Of the patients with early-stage [International Federation of Obstetrics and Gynecology (FIGO) stage IB2 or below] SCNEC, 57.8 and 79.3% underwent radical hysterectomy followed by adjuvant therapy. In advanced-stage SCNEC, concurrent chemoradiation therapy was given to 51.4% of the patients. The overall recurrence rate was 51.6%. In early- and advanced-stage SCNEC, the TTP was not different (22.3 vs. 13.3 months, p = 0.104), but the OS was different (40.7 vs. 21.4 months, p = 0.029). Parametrial involvement and lymph vascular space invasion were found to be associated with an unfavorable prognosis. Interestingly, survival was the most unfavorable in patients with early-stage SCNEC who had never received chemotherapy. FIGO stage and use of chemotherapy were identified as independent prognostic factors in SCNEC patients. Conclusions: SCNEC requires systemic chemotherapy as part of the initial treatment, along with surgery or radiation, even in patients with early-stage disease.

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High-Grade Neuroendocrine Carcinoma of the Cervix

Cited by 9 publications

References 61 publications

Neuroendocrine carcinoma of the cervix: a systematic review of the literature

Neuroendocrine carcinoma of the cervix: a systematic review of the literature

NECScanNet: Novel Method for Cervical Neuroendocrine Cancer Screening from Whole Slide Images

A Multicenter Study of the Importance of Systemic Chemotherapy for Patients with Small-Cell Neuroendocrine Carcinoma of the Uterine Cervix

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