<p>Prognostic Factors and Local Treatment Modalities of Small-Cell Carcinoma of the Cervix: An Analysis According to the International Federation of Gynecology and Obstetrics Stage</p>

Abstract

Purpose: Small-cell carcinoma of the cervix (SCCC) is a rare type of cervical cancer. This study aimed to investigate the clinicopathological characteristics and survival as well as the optimal local treatment modalities for SCCC. Patients and Methods: We retrospectively evaluated the data of patients diagnosed with SCCC between 1988 and 2015 in our institutionthose included in the Surveillance, Epidemiology, and End Results (SEER) database and those in the Periodical Database. Kaplan-Meier method and Cox regression proportional hazard methods were used to evaluate overall survival (OS). A nomogram that could predict OS was constructed based on the Cox proportional hazard model. Results: In total, 695 patients were included in this study. The 5-year overall survival in FIGO stage I-IIA and IIB-IV patients was 45.7% and 14.4%, respectively (P <0.01). Univariate and multivariate analyses showed that lymph node status (P <0.01) and cancerdirected surgery (P <0.01) were independent prognostic factors for FIGO I-IIA stage patients, and age (P <0.05), tumor size (P <0.01), chemotherapy (P <0.01) and radiation (P <0.01) were independent prognostic factors for FIGO stage IIB-IV patients. Conclusion: Better prognosis was associated with negative lymph node status, no lymphatic vasculature, surgery, and early-stage patients. Furthermore, our data showed that the prognosis and treatment pattern varied depending on the FIGO stage, and that optimal treatment modalities included radical surgery for early-stage SCCC and chemoradiotherapy for advanced-stage SCCC. It is helpful to assess the individual prognosis of SCCC patients and choose personalized treatment modalities.

Small Cell Carcinoma as an Independent Prognostic Factor for Cervical Cancer Patients: A Population-Based Analysis

“…Patients with SmCC of cervix were much more likely than patients with SCC of cervix to present with larger tumor size, local lymph node involvement, distant metastasis and advanced disease stage, all of which might contribute to poorer survival in SmCC patients. These observations were in accordance with previous studies showing that FIGO stage, tumor size, distant metastases were important clinicopathological characteristics that dictated the survival of patients with cervical SmCC (27)(28)(29). Moreover, cox regression models in our study indicated that pathology SmCC and higher stage primarily led to poor prognosis of patients with cervical cancer.…”

Small Cell Carcinoma as an Independent Prognostic Factor for Cervical Cancer Patients: A Population-Based Analysis

“…Patients with SmCC of cervix were much more likely than patients with SCC of cervix to present with larger tumor size, local lymph node involvement, distant metastasis and advanced disease stage, all of which might contribute to poorer survival in SmCC patients. These observations were in accordance with previous studies showing that FIGO stage, tumor size and distant metastases were important clinicopathological characteristics that dictated the survival of patients with cervical SmCC [24][25][26]. Moreover, Cox regression models in our study indicated that pathology SmCC and higher stage primarily led to poor prognosis of patients with cervical cancer.…”

Neuroendocrine Neoplasms of the Gynecologic Tract

“…NENs are associated with a worse prognosis than non-NEN cervical malignancies [ 48 ]. The most frequently related prognostic factors for early-stage disease are FIGO stage [ 49 , 50 , 51 , 52 ], lymph node metastasis [ 49 , 52 , 53 , 54 ], parametrial invasion, tumor size [ 55 , 56 , 57 , 58 ], lymphovascular space involvement, histological heterogeneity, older age [ 56 , 59 , 60 , 61 , 62 ], and smoking [ 56 , 63 , 64 ]. Of all these, Ishikawa et al reported LVSI as the most significant prognostic factor for overall and disease-free survival.…”