Objective: An evaluation of the prognostic factors of patients with surgically treated high-grade neuroendocrine carcinoma of the cervix (NECC). Design: A multi-center, retrospective analysis Setting and Population: 58 cases Methods: 58 patients with stage IIA1-IIIC cervical cancer who had high-grade NECC and were initially treated with surgery between 2009 and 2022 was conducted. We divided them into two groups based on pathology: the pure cohort (only one histological type) and the mixed group (≥2 histological types). All clinicopathological characteristics of patients were reviewed retrospectively using electronic medical records. Main Outcome Measures: Survival outcomes of NECC, clinicopathological characteristics and various related factors were analysed. Results: The median overall survival (OS) was 32.5 months (range: 4.1–60.9). The mixed pathology was a protective factor impacting survival outcomes in NECC (HR,0.02; 95% CI, 0.00~0.45, P=0.014). In contrast, uterus invasion (HR, 24.5; 95%CI, 1.37~439.31, P=0.03) was a poor prognostic factor affecting the survival outcomes in NECC. In addition, among all postoperative adjuvant chemotherapy options, etoposide + platinum (EP) showed better survival outcome (HR,0.04; 95% CI, 0.00~0.89, P=0.041). According to the Kaplan-Meier survival curves, significant differences were observed with respect to mixed pathology (P=0.044), uterus invasion (P＜0.0001), parametrium invasion (P=0.025), surgical margin (P=0.035), and distant metastasis (P＜0.0001). Conclusions: Patients with mixed pathological subtypes who undergo surgery for NECC have a better prognosis. Meanwhile, uterus invasion is a poor predictor of prognosis. In terms of postoperative adjuvant chemotherapy, the EP regimen is superior to other regimens. (The trial registration number: ChiCTR2200063023)

Objective: To investigate the long-term outcomes and optimal timing of surgery for Mayer–Rokitansky–Küster–Hauser syndrome (MRKH) patients undergoing vaginoplasty using an acellular porcine small intestinal submucosa graft (SIS). Design: Observational study. Setting and Population: Seventy-eight MRKH syndrome patients, forty-eight healthy controls and a post-SIS patient who delivered a baby following the world’s first robot-assisted uterus transplantation. Methods: The outcome of sexual function and psychological were assessed through three standard questionnaires: the female sexual function index (FSFI), Self-rating scale of body image (SSBI) and self-acceptance questionnaire (SAQ). Main Outcome Measures: Sexual function and psychology outcomes. Results: A total of 89.7% patients achieved a “good” vaginal width, and the mean vaginal length was 6.92±0.80 cm. The overall FSFI score of MRKH syndrome patients was significantly lower than that of healthy controls (24.43±4.42 versus 30.28±2.61, P<0.001). Three factors (sexual arousal, orgasm and sexual satisfaction score) in the FSFI increased significantly as the postoperative time increased. The emotional impairment factor of the SSBI showed a higher score in MRKH syndrome patients (1.56±1.83 versus 1.15±2.05, P=0.030). The psychological scale score showed an improving trend as the postoperative time was prolonged in MRKH syndrome patients. Conclusions: SIS surgery is effective in improving the patient’s sexual function and psychological problems, and this effect is more pronounced in patients who have the surgery earlier. It is recommended to undergo surgery when the patient is physiologically mature and expresses the desire to proceed with therapy.

Objective The COVID-19 pandemic has had a significant impact on oncogynecologic patients worldwide, particularly with respect to delayed diagnosis and treatment. During the COVID-19 pandemic, few studies have examined the impact of delayed surgery on survival in early-stage cervical cancer patients. The purpose of this study was to determine the effect of delayed surgical time on survival in patients with early cervical cancer. Design A retrospective cohort study. Setting A single general hospital in Shaanxi, Northwest China. Population A total of 1207women with early cervical cancer were recruited between April 2013 and December 2018 in Mainland China and followed up until 29 Feb 2022. Methods This retrospective cohort study was conducted in a comprehensive tertiary hospital in Shaanxi, Xi’an, China. We used a Cox proportional hazard model with delay time in weeks as a categorical variable to analyse the effect of surgical delay time on survival. Main Outcome Measures The 5-year overall and disease-free survival were used as the primary outcome measures. Results A total of 800 participants were included in the final cohort. In the multivariate Cox regression analysis (median follow-up, 58 months), patients in the long delay time group had DFS (5-year rates, 91.5% versus 90.9%, HR 0.99, 95% CI 0.62~1.59, P=0.98) and OS (5-year rates of 92.9% versus 90.8%, HR 0.68, 95% CI 0.42~1.10, P=0.11) similar to those in the short delay time group. Conclusions Our findings indicate that a 12-week delay in surgery is not associated with long-term survival in women with early-stage cervical cancer.