Small cell carcinoma of cervix: A population-based study evaluating standardized provincial treatment protocols

Abstract

ObjectivesTo describe the patient characteristics, patterns of treatment, and outcome of patients with small cell carcinoma of Cervix (SmCC) treated with radical radiotherapy from a provincial cancer registry database.MethodsOverall 25 patients with SmCC were treated with radical radiotherapy (with or without chemotherapy) from January 1, 1994 to December 31, 2013. Nineteen patients had pure SmCC while 6 had additional neuroendocrine component. Patients were treated with combined chemo-radiotherapy using multi-agent chemotherapy with pelvic or combined pelvic and para-aortic radiotherapy. All patients received brachytherapy. Use of prophylactic cranial irradiation was dependent on physician discretion. Survival was estimated using Kaplan-Meier method and compared using log-rank test.ResultsWe report a median overall survival of 53.8 months for our cohort. After a median follow-up of 54 months for surviving patients, the overall survival (OS) and progression free survival (PFS) at 5-years were 48% and 46.4% respectively. Patients with stage I-IIA disease had superior 5-year PFS (67.3% vs. 11.1%; p = .004) and 5-year OS (62.5% vs. 22.2%; p = .006). Patients with node-negative disease had a trend towards better 5-year PFS (55.7% vs. 19%; p = .07) and OS (61.1% vs. 14.3% at 5-years; p = .06) Distant metastasis was the predominant site of disease progression (n = 12; 48%).ConclusionDistant metastasis is the predominant pattern of failure for patients with SmCC treated with radical chemo-radiotherapy. With modern chemo-radiotherapy protocols we can expect a 5 year survival of around 50%. Early stage and node-negative status appear to be favorable prognostic factors with survival rates at 5-year over 60%.

Outcomes and prognostic factors of neuroendocrine cervical cancer in the National Cancer Institute of Thailand: A retrospective cohort study

“…An unexpected result in our study which was contrast to previously reported findings were the comparable survival outcomes among patients with early and advanced stages NECC [11,[12][13][14][15][16][17]. Our findings may suggest that the routine procedure used for staging cervical cancer may be inappropriate for NECC.…”

<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>

“…25 The role of chemotherapy is particularly emphasized in the treatment of SCCC. Some researchers believe that SCCC has similar invasiveness to small cell lung cancer; 32,33 thus, the treatment of SCCC is similar to that of small cell lung cancer, which is mainly treated by chemotherapy, [34][35][36][37][38] postoperative adjuvant chemotherapy is recommended even in early-stage disease. In our study, chemotherapy had a prognostic benefit only in advanced-stage patients, but not in early-stage patients.…”

a case report of small cell carcinoma of uterine cervix

“…A large case series of extrapulmonary small cell carcimas from England identified 76 cervix cases out of 1618 (4,69%) (13).Other small series have reported different numbers. For example a case series from South Korea published in 2004 reported a 29% rate for a cervical site (14) As previously stated, presentation and clinical manifestations of SCCC is the same as other cervical cancers.…”