Research
Oncology
Small cell carcinoma of the cervix: treatment and survival outcomes of 188 patients

https://doi.org/10.1016/j.ajog.2010.04.019Get rights and content

Objective

To determine the clinicopathologic factors associated with survival in neuroendocrine small cell cervical cancer patients.

Study Design

Patients were identified from a review of literature with an additional 52 patients from four hospitals. Kaplan-Meier and Cox regression methods were used for analyses.

Results

Of 188 patients, 135 had stages I-IIA, 45 stages IIB-IVA, and 8 stage IVB disease. A total of 55.3% underwent surgery, 16.0% had chemoradiation, 12.8% radiation, and 3.2% chemotherapy alone. The 5-year disease-specific survival in stage I-IIA, IIB-IVA, and IVB disease was 36.8%, 9.8%, and 0%, respectively (P < .001). Adjuvant chemotherapy or chemoradiation was associated with improved survival in patients with stages IIB-IVA disease compared with those who did not receive chemotherapy (17.8% vs 6.0%; P = .04). On multivariable analysis, early-stage disease and use of chemotherapy or chemoradiation were independent prognostic factors for improved survival.

Conclusion

Use of adjuvant chemotherapy or chemoradiation was associated with higher survival in small cell cervical cancer patients.

Section snippets

Materials and Methods

Fifty-two patients with neuroendocrine small cell cervical carcinoma who received diagnoses from 1979-2005 were identified from tumor registry databases at 4 hospitals (University of California-San Francisco, Stanford University, University of California-Irvine Medical Center, and Long Beach Memorial Medical Center). After institutional review board approval from these institutions, data were collected from hospital charts, office records, and tumor registry files. The remaining 136 patients

Results

Of 188 patients, 135 had stage I-IIA, 45 had IIB-IVA, and 8 had stage IVB disease.8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26, 27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40, 41, 42, 43, 44, 45, 46 The median age was 42 years (range, 20–87 years). Demographic characteristics of the patients are shown in Table 1. Vaginal bleeding at presentation was noted in 21.8% of patients and 8% had pain and pressure. Of 115 patients with tumor size documented, 80.0% had

Comment

Small cell cervical carcinoma is rare and is associated with a poor prognosis.47 The Gynecologic Oncology Group attempted to study small cell cervical carcinoma in protocol 66 between 1982 and 1986, but failed to recruit sufficient numbers of patients. As a result, treatment decisions have been based on these small single institution studies, and have extrapolated treatment approaches from the management of small cell cancer of the lung. With 188 patients in this report, to our knowledge, this

References (52)

  • I.A. Tabbara et al.

    Treatment of small-cell carcinoma of the cervix with weekly combination chemotherapy

    Eur J Cancer

    (1990)
  • D.M. Boruta et al.

    Multimodality therapy in early-stage neuroendocrine carcinoma of the uterine cervix

    Gynecol Oncol

    (2001)
  • J. Stassart et al.

    Argyrophilic carcinoma of the cervix: a report of a case with coexisting cervical intraepithelial neoplasia

    Gynecol Oncol

    (1982)
  • A.N. Husain et al.

    Synchronous adenocarcinoma and carcinoid of the uterine cervix: immunohistochemical study of a case and review of literature

    Gynecol Oncol

    (1989)
  • Y.B. Kim et al.

    Successful treatment of neuroendocrine small cell carcinoma of the cervix metastatic to regional lymph nodes

    Gynecol Oncol

    (1996)
  • E. Barranger et al.

    Metastasis on a Schuchardt incision after Schauta-Amreich operation for cervical carcinoma

    Gynecol Oncol

    (2004)
  • J.M. Lee et al.

    Prognostic factors in FIGO stage IB-IIA small cell neuroendocrine carcinoma of the uterine cervix treated surgically: results of a multi-center retrospective Korean study

    Ann Oncol

    (2008)
  • A. Rossi et al.

    New targeted therapies and small-cell lung cancer

    Clin Lung Cancer

    (2008)
  • K. Dickersin et al.

    Publication bias and clinical trials

    Control Clin Trials

    (1987)
  • S. Tsunoda et al.

    Small-cell carcinoma of the uterine cervix: a clinicopathologic study of 11 cases

    Int J Gynecol Cancer

    (2005)
  • H.H. Chung et al.

    Cervical cancer incidence and survival in Korea: 1993-2002

    Int J Gynecol Cancer

    (2006)
  • J. Albores-Saavedra et al.

    Terminology of endocrine tumors of the uterine cervix: results of a workshop sponsored by the College of American Pathologists and the National Cancer Institute

    Arch Pathol Lab Med

    (1997)
  • J. Hintze

    Number cruncher statistical systems

    (2001)
  • D.J. Gersell

    Small-cell undifferentiated carcinoma of the cervix: a clinicopathologic, ultrastructural, and immunocytochemical study of 15 cases

    Am J Surg Pathol

    (1988)
  • B.U. Sevin et al.

    Efficacy of radical hysterectomy as treatment for patients with small cell carcinoma of the cervix

    Cancer

    (1996)
  • A.N. Walker et al.

    Cervical neuroendocrine carcinoma: a clinical and light microscopic study of 14 cases

    Int J Gynecol Pathol

    (1988)
  • Cited by (180)

    • High grade neuroendocrine carcinoma of the cervix

      2023, Diagnosis and Treatment of Rare Gynecologic Cancers
    View all citing articles on Scopus

    Cite this article as: Cohen JG, Kapp DS, Shin JY, et al. Small cell carcinoma of the cervix: treatment and survival outcomes of 188 patients. Am J Obstet Gynecol 2010;203:347.e1-6.

    Reprints not available from the authors.

    View full text