Data from small cell neuroendocrine carcinoma of cervix: FIGO 2018 staging is more accurate than FIGO 2009

Abstract Background: To evaluate whether the addition of stage IIIC to the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system of cervical cancer is reasonable based on small cell neuroendocrine carcinomas of cervix (SCNEC) data.Methods: We retrospectively reviewed 64 SCNEC patients with FIGO 2009 stage IB–IIA from January 2014 to December 2018 at the author’s hospital.Results: Univariate analysis showed that FIGO 2018 was related to more prognostic factors than FIGO 2009. Multivariate analysis showed the FIGO stage and the degree of lymph node metastasis (LNM) were significantly related to the prognosis of SCNEC patients. The 5-year overall survival rate (OS) was 78.5% and 22.2% in stage I and II, respectively (FIGO 2009). In FIGO 2018, the 5-year OS was 74.1%, 60.2%, and 0% in stage I/II, IIIC1, and IIIC2, respectively. After IIIC stage was subgrouped by T factor (T1, limited to cervix and vagina; T2, parametrial involvement; T3, pelvic and abdominal cavity involvement), the 5-year OS of IIICT1,IIICT2, and IIICT3 was 83.3%, 30.0%, and 0%, respectively, (P=0.010); while by N factor (N1a and N1b, metastasis to pelvic with the rate ≤0.20 and >0.20; N1c, metastasis to the para-aortic), the 5-year OS of IIICN1a, IIICN1b, and IIICN1c was 80.0%, 26.7%, and 0%, respectively (P=0.016).Conclusion: Compared with FIGO 2009, FIGO 2018 can evaluate the prognosis of SCNEC patients more accurately after subdivision of stage IIIC by combining tumor local invasion factors or the degree and location of LNM.