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

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.