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280 Li et al. | Journal of Clinical and Translational Research 2023; 9(4): 272-281
that less than four cycles of chemotherapy were associated with Tract: A Multifaceted Spectrum of Lesions. Gynecol Oncol
lower OS in patients with cervical neuroendocrine tumors. In our 2014;134:410-8.
cohort, compared with less than four cycles of chemotherapy, four [6] Gardner GJ, Reidy-Lagunes D, Gehrig PA. Neuroendocrine
or more cycles were associated with significantly higher 3-year Tumors of the Gynecologic Tract: A Society of Gynecologic
PFS (46.4% vs. 34.1%) and 5-year PFS (40.4% vs. 25.7%) and Oncology (SGO) Clinical Document. Gynecol Oncol
significantly higher 3-year OS (57.6% vs. 31.6%) and 5-year OS 2011;122:190-8.
(48.6% vs. 25.2%). [7] Zhang Y, Li L, Wang Z, Huang Y, Luo S, Peng Y, et al.
This study has limitations. First, the small number of cases Preferred Method of Therapy for Patients with Early-stage
with a complete follow-up, the single-center design, and changes High-grade Neuroendocrine Carcinoma of the Cervix. Am
in the treatment plan and FIGO staging during the study period J Cancer Res 2021;11:4595-606.
(2009 – 2020) may have caused bias in selection, implementation, [8] Cohen PA, Jhingran A, Oaknin A, Denny L. Cervical
and measurements. Second, the retrospective design did not allow Cancer. Lancet 2019;393:169-82.
assessing the clinical effects of anti-PD-L1 therapies in NECC.
Third, immunohistochemistry has a limited ability to detect PD- [9] De Felice F, Marchetti C, Palaia I, Ostuni R, Muzii L,
L1 because of the heterogeneity of PD-L1 expression in tumor Tombolini V, et al. Immune Check-point in Cervical
specimens. Cancer. Crit Rev Oncol Hematol 2018;129:40-3.
[10] Towner M, Novak K, Chae YK, Matei D. Ipilimumab
5. Conclusion and Nivolumab for Recurrent Neuroendocrine Cervical
Carcinoma. Gynecol Oncol Rep 2022;42:101039.
Positive PD-L1 expression was associated with higher 3-year
PFS in patients with mixed histology. RT for patients with early [11] Badoual C, Hans S, Merillon N, Van Ryswick C,
NECC has the same effect as surgery and is effective for treating Ravel P, Benhamouda N, et al. PD-1-expressing Tumor-
locally advanced disease. Four or more cycles of chemotherapy infiltrating T Cells are a Favorable Prognostic Biomarker
are more effective than a smaller number of courses. Prophylactic in HPV-associated Head and Neck Cancer. Cancer Res
EFI did not significantly improve PFS and OS. Nonetheless, the 2013;73:128-38.
effects of prophylactic EFI should be further studied. [12] Droeser RA, Hirt C, Viehl CT, Frey DM, Nebiker C,
Huber X, et al. Clinical Impact of Programmed Cell Death
Acknowledgments Ligand 1 Expression in Colorectal Cancer. Eur J Cancer

None. 2013;49:2233-42.
[13] Thompson RH, Dong H, Lohse CM, Leibovich BC,
Funding Blute ML, Cheville JC, et al. PD-1 is Expressed by Tumor-
infiltrating Immune Cells and is Associated with Poor
Not applicable. Outcome for Patients with Renal Cell Carcinoma. Clin
Conflicts of Interest Cancer Res 2007;13:1757-61.
[14] Loharamtaweethong K, Puripat N, Praditphol N,
The authors declare no conflict of interest regarding the Thammasiri J, Tangitgamol S. PD-L1 Protein Expression
publication of this paper. and Copy Number Gains in HIV-positive Locally Advanced

References Cervical Cancer. Ther Adv Med Oncol 2020;12:1-15.
[15] Alejo M, Alemany L, Clavero O, Quiros B, Vighi S,
[1] Gadducci A, Carinelli S, Aletti G. Neuroendrocrine Seoud M, et al. Contribution of Human Papillomavirus in
Tumors of the Uterine Cervix: A Therapeutic Challenge for Neuroendocrine Tumors from a Series of 10,575 Invasive
Gynecologic Oncologists. Gynecol Oncol 2017;144:637-46. Cervical Cancer Cases. Papillomavirus Res 2018;5:134-42.
[2] Burzawa J, Gonzales N, Frumovitz M. Challenges in the [16] Morgan S, Slodkowska E, Parra-Herran C,
Diagnosis and Management of Cervical Neuroendocrine Mirkovic J. PD-L1, RB1 and Mismatch Repair Protein
Carcinoma. Expert Rev Anticancer Ther 2015;15:805-10. Immunohistochemical Expression in Neuroendocrine
[3] Salvo G, Martin AG, Gonzales NR, Frumovitz M. Updates Carcinoma, Small Cell Type, of the Uterine Cervix.
and Management Algorithm for Neuroendocrine Tumors of Histopathology 2019;74:997-1004.
the Uterine Cervix. Int J Gynecol Cancer 2019;29:986-95. [17] Ji X, Sui L, Song K, Lv T, Zhao H, Yao Q. PD-L1,
[4] Kitajima K, Kihara T, Kawanaka Y, Kido A, Yoshida K, PARP1, and MMRS as Potential Therapeutic Biomarkers
Mizumoto Y, et al. Neuroendocrine Carcinoma of for Neuroendocrine Cervical Cancer. Cancer Med
Uterine Cervix Findings Shown by MRI for Staging and 2021;10:4743-51.
Survival Analysis-Japan Multicenter Study. Oncotarget [18] Chen L, Yang F, Feng T, Wu S, Li K, Pang J, et al.
2020;11:3675-86. PD-L1, Mismatch Repair Protein, and NTRK
[5] Atienza-Amores M, Guerini-Rocco E, Soslow RA, Park KJ, Immunohistochemical Expression in Cervical Small Cell
Weigelt B. Small Cell Carcinoma of the Gynecologic Neuroendocrine Carcinoma. Front Oncol 2021;11:752453.
DOI: http://dx.doi.org/10.18053/jctres.09.202304.23-00067