Small cell neuroendocrine carcinoma of the cervix: Analysis of outcome, recurrence pattern and the impact of platinum-based combination chemotherapy

• Published in: Gynecologic oncology Vol. 112; no. 3; pp. 590 - 593
• Main Authors: Zivanovic, O, Leitao, M.M, Park, K.J, Zhao, H, Diaz, J.P, Konner, J, Alektiar, K, Chi, D.S, Abu-Rustum, N.R, Aghajanian, C
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01-03-2009
• Subjects: Adult; Antineoplastic Combined Chemotherapy Protocols - therapeutic use; Carboplatin - administration & dosage; Carcinoma, Neuroendocrine - drug therapy; Carcinoma, Neuroendocrine - pathology; Carcinoma, Neuroendocrine - radiotherapy; Carcinoma, Neuroendocrine - surgery; Carcinoma, Small Cell - drug therapy; Carcinoma, Small Cell - pathology; Carcinoma, Small Cell - radiotherapy; Carcinoma, Small Cell - surgery; Cervix; Cisplatin - administration & dosage; Etoposide - administration & dosage; Female; Hematology, Oncology and Palliative Medicine; Humans; Middle Aged; Neoplasm Recurrence, Local - pathology; Neoplasm Staging; Obstetrics and Gynecology; Platinum-based chemotherapy; Retrospective Studies; Small cell neuroendocrine carcinoma; Treatment Outcome; Uterine Cervical Neoplasms - drug therapy; Uterine Cervical Neoplasms - pathology; Uterine Cervical Neoplasms - radiotherapy; Uterine Cervical Neoplasms - surgery; Small cell neuroendocrine carcinoma; Cervix; Platinum-based chemotherapy
• ISSN: 0090-8258; 1095-6859
• DOI: 10.1016/j.ygyno.2008.11.010

Abstract Objectives To analyze progression-free (PFS) and overall survival (OS) in patients with small cell neuroendocrine carcinoma of the cervix (SCNEC), and to determine whether platinum-based combination chemotherapy is beneficial for this population. Methods We performed a retrospective analysis of all patients with SCNEC who were treated at our institution between 1/1990 and 2/2007. Patients were excluded if pathologic diagnosis was not confirmed at our institution. Standard statistical methods were utilized. Results Seventeen patients met inclusion criteria. The estimated 3-year PFS and OS rates for the entire group were 22% and 30%, respectively. Median time to progression was 9.1 months. Extent of disease was the only significant prognostic factor. Median OS for patients with early stage disease (IA1–IB2) was 31.2 months and 6.4 months for patients with advanced stage disease (IIB–IV, P = 0.034). In the early-stage disease group, the 3-year distant recurrence-free survival rate was 83% for patients who received chemotherapy and 0% for patients who did not receive chemotherapy as part of their initial treatment ( P = 0.025). The estimated 3-year OS rate was 83% for patients who received and 20% for patients who did not receive chemotherapy as part of their initial treatment ( P = 0.36). Conclusion Given the rarity of SCNEC this retrospective analysis is limited by a small number of patients. However, the natural history of this rare disease is akin to small cell lung cancer and the prognosis is poor due to the tumor's propensity for distant spread. The treatment should conform to the treatment of small cell lung cancer.