Abstract
BackgroundStandard treatments for small cell carcinoma of the cervix (SCCC) have not been established. In this study, we aimed to estimate the optimal treatment strategy for SCCC.MethodsThis was a multicenter retrospective study. Medical records of patients with pathologically proven SCCC treated between 2003 and 2016 were retrospectively analyzed. Overall survival (OS) was plotted using the Kaplan-Meier method. Log-rank tests and Cox regression analysis were used to assess the differences in survival according to stage, treatment strategy, and chemotherapy regimen.ResultsData of 78 patients were collected, and after excluding patients without immunohistopathological staining, 65 patients were evaluated. The median age of the included patients was 47 (range: 24–83) years. The numbers of patients with International Federation of Gynecology and Obstetrics (FIGO) 2018 stages I-IIA, IIB-IVA, IVB were 23 (35%), 34 (52%), and 8 (12%), respectively. Of 53 patients who had undergone chemotherapy, 35 and 18 received SCCC and non-SCCC regimens as their first-line chemotherapy regimen, respectively. The 5-year OS for all patients was 49%, while for patients with FIGO stages I-IIA, IIB-IVA, IVB, it was 60, 50, and 0%, respectively. The 5-year OS rates for patients who underwent treatment with SCCC versus non-SCCC regimens were 59 and 13% (p < 0.01), respectively. This trend was pronounced in locally advanced stages. Multivariate analysis showed that FIGO IVB at initial diagnosis was a significant prognostic factor in all patients. Among the 53 patients who received chemotherapy, the SCCC regimen was associated with significantly better 5-year OS in both the uni- and multivariate analyses.ConclusionOur results suggest that the application of an SCCC regimen such as EP or IP as first-line chemotherapy for patients with locally advanced SCCC may play a key role in OS. These findings need to be validated in future nationwide, prospective clinical studies.
Highlights
Standard treatments for small cell carcinoma of the cervix (SCCC) have not been established
Chemoradiotherapy is recommended for patients with advanced disease or those without indication for surgery, and chemoradiotherapy with etoposide/cisplatin (EP) combined with pelvic radiation is recommended based on data from multiple small retrospective cohort studies on prognostic factors of SCCC
After the publication of the document from the Society of Gynecologic Oncology in 2011, more institutions started to treat this disease as localized SCCC; the outcomes from this treatment approach still need to be evaluated., it has been reported that the irinotecan/cisplatin (IP) regimen for small cell lung cancer is as effective as EP [4], and since small cell carcinoma of the cervix and lungs have a similar protein expression [5], IP can be effective in both SCCC and small cell carcinoma of the lungs; the existing data are limited
Summary
Standard treatments for small cell carcinoma of the cervix (SCCC) have not been established. Chemoradiotherapy is recommended for patients with advanced disease or those without indication for surgery, and chemoradiotherapy with etoposide/cisplatin (EP) combined with pelvic radiation is recommended based on data from multiple small retrospective cohort studies on prognostic factors of SCCC. After the publication of the document from the Society of Gynecologic Oncology in 2011, more institutions started to treat this disease as localized SCCC; the outcomes from this treatment approach still need to be evaluated., it has been reported that the irinotecan/cisplatin (IP) regimen for small cell lung cancer is as effective as EP [4], and since small cell carcinoma of the cervix and lungs have a similar protein expression [5], IP can be effective in both SCCC and small cell carcinoma of the lungs; the existing data are limited
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