Prognostic factors and treatment comparison in early‑stage small cell carcinoma of the uterine cervix

Tian,W. J.; Zhang,M. Q.; Shui,R. H.

doi:10.3892/ol.2011.439

Prognostic factors and treatment comparison in early‑stage small cell carcinoma of the uterine cervix

Authors:
- W. J. Tian
- M. Q. Zhang
- R. H. Shui
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Affiliations: Department of Gynecologic Oncology, Shanghai Cancer Center, Fudan University, Shanghai 200032, P.R. China, Department of Pathology, Shanghai Cancer Center, Fudan University, Shanghai 200032, P.R. China
Published online on: October 12, 2011 https://doi.org/10.3892/ol.2011.439
Pages: 125-130

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Abstract

Small cell carcinoma of the uterine cervix (SCCUC) is rare and its biologic behavior is aggressive. To analyze prognostic factors and determine optimal therapy in patients with International Federation of Gynecology and Obstetrics (FIGO) stage IB1-IIA SCCUC, we retrospectively reviewed 96 patients (14 patients treated in our center and 82 patients identified by a search on PubMed) treated with radical surgery (SU), surgery plus adjuvant chemotherapy (SU+Chemo), or surgery plus adjuvant chemotherapy and radiotherapy (SU+Chemo+RT) between 1990 and 2010. Of the 96 patients, 11 patients were treated with SU, 33 with SU+Chemo, and 52 with SU+Chemo+RT. The 5-year survival rate for the 96 patients was 45%. A total of 6% (2/32) of patients had local recurrence, 75% (24/32) had distant metastases, and 19% (6/32) had both. The 5-year survival rate in stage IB1 and IB2-IIA disease was 58 and 34%, respectively (P=0.049). For patients with and without lymph node metastases (LNM), survival was 33 and 60%, respectively (P=0.045). Patients with inner 1/3 stromal invasion had a better survival than those with deep stromal invasion (DSI) (100 vs. 34%, P=0.003). Survival was not significantly different in patients treated with the above three modalities, albeit treatment selection was related to LNM (P=0.000) and DSI (P=0.027). Thus, FIGO stage, LNM and DSI are significant predictors of survival. Adjuvant therapy after SU has not improved survival compared with surgery alone. Thus, newer multimodality therapy should be evaluated.

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1	Chan JK, Loizzi V, Burger RA, Rutgers J and Monk BJ: Prognostic factors in neuroendocrine small cell cervical carcinoma: A multivariate analysis. Cancer. 97:568–574. 2003. View Article : Google Scholar : PubMed/NCBI
2	Lee JM, Lee KB, Nam JH, 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. 19:321–326. 2008. View Article : Google Scholar
3	Viswanathan AN, Deavers MT, Jhingran A, Ramirez PT, Levenback C and Eifel PJ: Small cell neuroendocrine carcinoma of the cervix: outcome and patterns of recurrence. Gynecol Oncol. 93:27–33. 2004. View Article : Google Scholar : PubMed/NCBI
4	Tsunoda S, Jobo T, Arai M, et al: Small-cell carcinoma of the uterine cervix: A clincopathologic study of 11 cases. Int J Gynecol Cancer. 15:295–300. 2005. View Article : Google Scholar : PubMed/NCBI
5	Chen J, MacDonald OK and Gaffney DK: Incidence, mortality, and prognostic factors of small cell carcinoma of the cervix. Obstet Gynecol. 111:1394–1402. 2008. View Article : Google Scholar : PubMed/NCBI
6	Lee SW, Nam JH, Kim DY, Kim JH, Kim KR, Kim YM and Kim YT: Unfavorable prognosis of small cell neuroendocrine carcinoma of the uterine cervix: a retrospective matched case-control study. Int J Gynecol Cancer. 20:411–416. 2010. View Article : Google Scholar : PubMed/NCBI
7	Abeler VM, Holm R, Nesland JM and Kjorstad KE: Small cell carcinoma of the cervix: a clinicopathologic study of 26 patients. Cancer. 73:672–677. 1994. View Article : Google Scholar : PubMed/NCBI
8	Sheets EE, Berman ML, Hrountas CK, Liao SY and DiSaia PJ: Surgically treated, early-stage neuroendocrine small-cell cervical carcinoma. Obstet Gynecol. 71:10–14. 1998.
9	Sevin BU, Method MW, Nadji M, Lu Y and Averette HA: Efficacy of radical hysterectomy as treatment for patients with small cell carcinoma of the cervix. Cancer. 77:1489–1493. 1996. View Article : Google Scholar : PubMed/NCBI
10	Albores-Saavedra J, Gersell D, Gilks CB, 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. 121:34–39. 1997.
11	O’Hanlan KA, Goldberg GL, Jones JG, Runowicz CD, Ehrlich L and Rodriguez-Rodriguez L: Adjuvant therapy for neuroendocrine small cell carcinoma of the cervix: review of the literature. Gynecol Oncol. 43:167–172. 1991.PubMed/NCBI
12	Morris M, Gershenson DM, Eifel P, et al: Treatment of small cell carcinoma of the cervix with cisplatin, doxorubicin, and etoposide. Gynecol Oncol. 47:62–65. 1992. View Article : Google Scholar : PubMed/NCBI
13	Hoskins PJ, Wong F, Swenerton KD, et al: Small cell carcinoma of the cervix treated with concurrent radiotherapy, cisplatin, and etoposide. Gynecol Oncol. 56:218–225. 1995. View Article : Google Scholar : PubMed/NCBI
14	Kim YB, Barbuto D, Lagasse LD and Karlan BY: Successful treatment of neuroendocrine small cell carcinoma of the cervix metastatic to regional lymph nodes. Gynecol Oncol. 62:411–414. 1996. View Article : Google Scholar : PubMed/NCBI
15	Wang PH, Liu YC, Lai CR, Chao HT, Yuan CC and Yu KJ: Small cell carcinoma of the cervix: analysis of clinical and pathological findings. Eur J Gynaecol Oncol. 19:189–192. 1998.PubMed/NCBI
16	Sykes AJ, Shanks JH and Davidson SE: Small cell carcinoma of the uterine cervix: a clinicopathological review. Int J Oncol. 14:381–386. 1999.PubMed/NCBI
17	Lim FK, Chong SM and Sethi V: Small cell neuroendocrine carcinoma of the cervix with involvement of multiple pelvic nodes: a successfully treated case by multimodal approach. Gynecol Oncol. 72:246–249. 1999. View Article : Google Scholar : PubMed/NCBI
18	Chang TC, Hsueh S, Lai CH, et al: Phase II trial of neoadjuvant chemotherapy in early-stage small cell cervical cancer. Anticancer Drugs. 10:641–646. 1999. View Article : Google Scholar : PubMed/NCBI
19	Delaloge S, Pautier P, Kerbrat P, et al: Neuroendocrine small cell carcinoma of the uterine cervix: what disease? what treatment? Report of ten cases and a review of the literature. Clin Oncol. 12:357–362. 2000. View Article : Google Scholar : PubMed/NCBI
20	Collinet P, Lanvin D, Declerck D, Chevalier-Place A, Leblanc E and Querleu D: Neuroendocrine tumors of the uterine cervix clinicopathologic study of five patients. Eur J Obstet Gynecol Reprod Biol. 91:51–57. 2000. View Article : Google Scholar : PubMed/NCBI
21	Straughn JM Jr, Richter HE, Conner MG, Meleth S and Barnes MN: Predictors of outcome in small cell carcinoma of the cervix: a case series. Gynecol Oncol. 83:216–220. 2001. View Article : Google Scholar : PubMed/NCBI
22	Ohwada M, Suzuki M, Hironaka M, Irie T and Sato I: Neuroendocrine small cell carcinoma of the uterine cervix showing polypoid growth and complicated by pregnancy. Gynecol Oncol. 81:117–119. 2001. View Article : Google Scholar : PubMed/NCBI
23	Boruta DM, Schorge JO, Duska LA, Crum CP, Castrillon DH and Sheets EE: Multimodality therapy in early-stage neuroendocrine carcinoma of the uterine cervix. Gynecol Oncol. 81:82–87. 2001. View Article : Google Scholar : PubMed/NCBI
24	Kim Y, Ha HJ, Kim JS, et al: Significance of cytologic smears in the diagnosis of small cell carcinoma of the uterine cervix. Acta Cytol. 46:637–644. 2002. View Article : Google Scholar : PubMed/NCBI
25	Trinh XB, Bogers JJ, van Marck EA and Tjalma WA: Treatment policy of neuroendocrine small cell cancer of the cervix. Eur J Gynaecol Oncol. 25:40–44. 2004.PubMed/NCBI
26	Masumoto N, Fujii T, Ishikawa M, et al: P16 overexpression and human papillomavirus infection in small cell carcinoma of the uterine cervix. Human Pathol. 34:778–783. 2003. View Article : Google Scholar : PubMed/NCBI
27	Petru E, Pasterk C, Reich O, Obermair A, Winter R and Breitenecker G: Small-cell carcinoma of the uterus and the vagina: experience with ten patients. Arch Gynecol Obstet. 271:316–319. 2005. View Article : Google Scholar : PubMed/NCBI
28	Korcum AF, Aksu G, Bozcuk H, Pestereli E and Simsek T: Small cell carcinoma of the cervix: a case report. Arch Gynecol Obstet. 277:367–370. 2008. View Article : Google Scholar : PubMed/NCBI
29	Kim MJ, Kim NR, Cho HY, Lee SP and Ha SY: Differential diagnostic features of small cell carcinoma in the uterine cervix. Diagn Cytopathol. 36:618–623. 2008. View Article : Google Scholar : PubMed/NCBI
30	Puig F, Rodrigo C, Munoz G and Lanzon R: Small cell neuroendocrine carcinoma of the cervix: report of two cases. Eur J Gynaecol Oncol. 30:321–322. 2009.PubMed/NCBI
31	Chang TC, Lai CH, Tseng CJ, Hsueh S, Huang KG and Chou HH: Prognostic factors in surgically treated small cell cervical carcinoma followed by adjuvant chemotherapy. Cancer. 83:712–718. 1998. View Article : Google Scholar : PubMed/NCBI
32	Huang CY, Chen YL, Chu TC, Cheng WF, Hsieh CY and Lin MC: Prognostic factors in women with early stage small cell carcinoma of the uterine cervix. Oncol Res. 18:279–286. 2009. View Article : Google Scholar : PubMed/NCBI
33	Zivanovic O, Leitao MM Jr, Park KJ, et al: Small cell neuroendocrine carcinoma of the cervix: analysis of outcome, recurrence pattern and the impact of platinum-based combination chemotherapy. Gynecol Oncol. 112:590–593. 2009. View Article : Google Scholar
34	Pazdur R, Bonomi P, Slayton R, et al: Neuroendocrine carcinoma of the cervix: implications for staging and therapy. Gynecol Oncol. 12:120–128. 1981. View Article : Google Scholar : PubMed/NCBI
35	Rossi A, Maione P, Palazzolo G, et al: New targeted therapies and small-cell lung cancer. Clin Lung Cancer. 9:271–279. 2008. View Article : Google Scholar : PubMed/NCBI