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已发表论文
子宫颈神经内分泌癌患者卵巢转移风险与预后分析：多中心回顾性队列研究
Authors He F , Zu S, Wang F, Wang H, Huang S
Received 19 September 2025
Accepted for publication 1 December 2025
Published 9 December 2025 Volume 2025:17 Pages 5303—5314
DOI https://doi.org/10.2147/IJWH.S564722
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 4
Editor who approved publication: Dr Vinay Kumar
Fangjie He,1 Shuiling Zu,1 Fuqiang Wang,2 Hongyan Wang,3 Shimin Huang4
1Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, People’s Republic of China; 2Department of Obstetrics and Gynecology, Anyang Cancer Hospital, Anyang, 455000, People’s Republic of China; 3Department of Obstetrics and Gynecology, Nanhai District People’s Hospital of Foshan, Foshan, 528000, People’s Republic of China; 4Department of Obstetrics and Gynecology, The First People’s Hospital of Foshan, Foshan, 528000, People’s Republic of China
Correspondence: Fangjie He, Email dr_hefangjie@163.com Shimin Huang, Email hsmin2008@163.com
Objective: To determine the risk of ovarian metastasis and prognosis in patients with neuroendocrine carcinoma of the uterine cervix (NECC).
Methods: A retrospective review was conducted of the clinical and pathological information of patients with stage IA2 to IIA2 cervical cancer who underwent radical hysterectomy between 2008 and 2023. Multivariate Cox proportional hazards regression models were used to identify independent prognostic factors for the 5-year overall survival (OS) and disease-free survival (DFS).
Results: The study included 1351 patients from four Chinese medical institutions. Compared to those with squamous carcinoma or adenocarcinoma, patients with NECC had a significantly higher risk of lymph vascular space invasion (LVSI) and more frequently received adjuvant radiotherapy. The overall rates of fallopian tube and ovarian metastases were low (< 1.0%). Furthermore, the ovary had a higher rate of metastasis than the fallopian tube (P< 0.001). Remarkably, none of the 75 patients with NECC exhibited fallopian tube or ovarian metastasis. The 5-year DFS and OS were significantly shorter in patients with NECC than in those with squamous carcinoma (5-year DFS, 64.7% vs 90.1%, P < 0.001; 5-year OS, 75.7% vs 89.6%, P < 0.001) or adenocarcinoma (5-year DFS, 64.7% vs 83.4%, P < 0.001; 5-year OS, 75.7% vs 88.7%, P=0.004). Multivariate analysis identified NECC as an independent risk factor for decreased 5-year DFS (aHR, 6.274; 95% CI, 3.749– 10.499) and 5-year OS (aHR, 5.925; 95% CI, 3.097– 11.336). Sensitivity assessments yielded consistent results.
Conclusion: NECC is an independent risk factor associated with a worse prognosis. However, the rates of fallopian tube and ovarian metastases are low in NECC patients, suggesting that ovarian preservation may be a safe and feasible option for these patients. Further validation in broader, diverse populations is warranted to generalize these findings.
Keywords: cervical cancer, neuroendocrine carcinoma, prognosis, fallopian tube, ovary
1Department of Gynecology, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, 350000, People’s Republic of China; 2Department of Obstetrics and Gynecology, Anyang Cancer Hospital, Anyang, 455000, People’s Republic of China; 3Department of Obstetrics and Gynecology, Nanhai District People’s Hospital of Foshan, Foshan, 528000, People’s Republic of China; 4Department of Obstetrics and Gynecology, The First People’s Hospital of Foshan, Foshan, 528000, People’s Republic of China
Correspondence: Fangjie He, Email dr_hefangjie@163.com Shimin Huang, Email hsmin2008@163.com
Objective: To determine the risk of ovarian metastasis and prognosis in patients with neuroendocrine carcinoma of the uterine cervix (NECC).
Methods: A retrospective review was conducted of the clinical and pathological information of patients with stage IA2 to IIA2 cervical cancer who underwent radical hysterectomy between 2008 and 2023. Multivariate Cox proportional hazards regression models were used to identify independent prognostic factors for the 5-year overall survival (OS) and disease-free survival (DFS).
Results: The study included 1351 patients from four Chinese medical institutions. Compared to those with squamous carcinoma or adenocarcinoma, patients with NECC had a significantly higher risk of lymph vascular space invasion (LVSI) and more frequently received adjuvant radiotherapy. The overall rates of fallopian tube and ovarian metastases were low (< 1.0%). Furthermore, the ovary had a higher rate of metastasis than the fallopian tube (P< 0.001). Remarkably, none of the 75 patients with NECC exhibited fallopian tube or ovarian metastasis. The 5-year DFS and OS were significantly shorter in patients with NECC than in those with squamous carcinoma (5-year DFS, 64.7% vs 90.1%, P < 0.001; 5-year OS, 75.7% vs 89.6%, P < 0.001) or adenocarcinoma (5-year DFS, 64.7% vs 83.4%, P < 0.001; 5-year OS, 75.7% vs 88.7%, P=0.004). Multivariate analysis identified NECC as an independent risk factor for decreased 5-year DFS (aHR, 6.274; 95% CI, 3.749– 10.499) and 5-year OS (aHR, 5.925; 95% CI, 3.097– 11.336). Sensitivity assessments yielded consistent results.
Conclusion: NECC is an independent risk factor associated with a worse prognosis. However, the rates of fallopian tube and ovarian metastases are low in NECC patients, suggesting that ovarian preservation may be a safe and feasible option for these patients. Further validation in broader, diverse populations is warranted to generalize these findings.
Keywords: cervical cancer, neuroendocrine carcinoma, prognosis, fallopian tube, ovary