Small Cell Carcinoma Of The Cervix Research Articles

Pan-Canadian Analysis of Practice Patterns in Small Cell Carcinoma of the Cervix: Insights from a Multidisciplinary Survey.

Small-cell neuroendocrine carcinoma of the cervix (SCNECC) is a rare cancer with poor prognosis, with limited data to guide its treatment. The objective of this study was to evaluate practice patterns in the management of SCNECC. A 23-question online survey on management of SCNECC was disseminated to Canadian gynecologic oncologists (GO), radiation oncologists (RO) and medical oncologists (MO). In total, 34 practitioners from eight provinces responded, including 17 GO, 13 RO and four MO. During staging and diagnosis, 74% of respondents used a trimodality imaging approach, and 85% tested for neuroendocrine markers. In early-stage (1A1-1B2) SCNECC, 87% of practitioners used a surgical-based approach with various adjuvant and neoadjuvant treatments. In locally advanced (1B3-IVA) SCNECC, 53% favored primary chemoradiation, with cisplatin and etoposide, with the remainder using surgical or radiation-based approaches. In metastatic and recurrent SCNECC, the most common first-line regimen was etoposide and platinum, and 63% of practitioners considered clinical trials in the first line setting or beyond. This survey highlights diverse practice patterns in the treatment of SCNECC. Interdisciplinary input is crucial to individualizing multimodality treatment, and there is a need for prospective trials and intergroup collaboration to define the optimal approach towards managing this rare cancer type.

Liquid-Based Cytology of Small Cell Carcinoma of the Cervix: A Multicenter Retrospective Study.

There are currently few reports describing the liquid-based cytological characteristics of small cell neuroendocrine carcinoma of the cervix. This study aimed to retrospectively analyze these features to reduce missed or misdiagnosis. A total of 11 patients with histologically diagnosed small cell carcinoma of the cervix from three hospitals between 2017 and 2023 were included in this study. The cytological morphology of small cell carcinoma of the cervix and causes of missed or misdiagnosis were analyzed and summarized through a review of clinical data, liquid-based cytology, histology, immunohistochemistry, and human papillomaviruses (HPV) test results. In this study, the positivity rate of preliminary cytological screening was 63.6% (7/11); however, no cases were accurately diagnosed as small cell carcinoma of the cervix. A total of 36.4% (4/11) of small cell carcinoma of the cervix cases were cytologically negative; retrospective cytology found that two of these were false negatives. The main cytological features of small cell carcinoma of the cervix were summarized. Most of the liquid-based cytology smear cells were dense, and almost all cases showed clustered and scattered cytoplasm-scanty tumor cells. The tumor cells were all deeply stained and relatively consistent small cells. Most cases showed typical nuclear molding, chromatin stippling, and no obvious nucleoli. Mild nuclear smears, nuclear fragments, and mitotic figures were seen in most cases. Liquid-based cytology has a high rate of missed diagnosis and misdiagnosis in small cell carcinoma of the cervix. This study confirms that reviewing cytology results can effectively reduce this proportion and that increasing understanding of small cell carcinoma of the cervix morphology is conducive to improving the cytology-based diagnosis rate.

Small Cell Carcinoma of the Cervix: A Case Report and Literature Review

Cervical small cell carcinoma (SCC) is a rare disease, with a high degree of malignancy and a poor prognosis. Para-aortic lymph nodes (PALN) are frequent sites of recurrence after pelvic chemoradiotherapy. In the present study, we report the case of a 26-year-old female patient with cervical SCC who suffered for two times PALN relapses. Our research results have shown that PALN lesions can be effectively controlled with permanent radiation therapy. Prophylactic PALN radiotherapy may be an effective option for patients with cervical SCC who require radical pelvic radiation therapy.

Quantitative proteomics analysis in small cell carcinoma of cervix reveals novel therapeutic targets

BackgroundAs a rare pathologic subtype, small cell carcinoma of the cervix (SCCC) is characterized by extensive aggressiveness and resistance to current therapies. To date, our knowledge of SCCC origin and progression is limited and sometimes even controversial. Herein, we explored the whole-protein expression profiles in a panel of SCCC cases, aiming to provide more evidence for the precise diagnosis and targeting therapy.MethodsEighteen SCCC samples and six matched normal cervix tissues were collected from January 2013 to December 2017. Data independent acquisition mass spectrometry (DIA) was performed to discriminate the different proteins (DEPs) associated with SCCC. The expression of CDN2A and SYP in corresponding SCCC tissues was verified using immunohistochemistry. GO and KEGG enrichment analyses were used to identify the key DEPs related to SCCC development and tumor recurrence.ResultsAs a result, 1311 DEPs were identified in SCCC tissues (780 up-regulated and 531 down-regulated). In up-regulated DEPs, both GO analysis and KEGG analysis showed the most enriched were related to DNA replication (including nuclear DNA replication, DNA-dependent DNA replication, and cell cycle DNA replication), indicating the prosperous proliferation in SCCC. As for the down-regulated DEPs, GO analysis showed that the most enriched functions were associated with extracellular matrix collagen-containing extracellular matrix. KEGG analysis revealed that the DEPs were enriched in Complement and coagulation cascades, proteoglycans in cancer, and focal adhesion-related pathways. Down-regulation of these proteins could enhance the mobility of cancer cells and establish a favorable microenvironment for tumor metastasis, which might be accounted for the frequent local and distant metastasis in SCCC. Surprisingly, the blood vessels and circulatory system exhibit a down-regulation in SCCC, which might be partly responsible for its resistance to anti-angiogenic regimens. In the stratification analysis of early-stage tumors, a group of enzymes involved in the cancer metabolism was discriminated in these recurrence cases.ConclusionsUsing quantitative proteomics analysis, we first reported the whole-protein expression profiles in SCCC. Significant alterations were found in proteins associated with the enhancement of DNA replication and cellular motility. Besides the association with mitosis, a unique metabolic feature was detected in cases with tumor recurrence. These findings provided novel targets for disease surveillance and treatments, which warranted further validation in the future.

Real-world Efficacy Data on Anti-Angiogenic Drugs in Recurrent Small Cell Cervical Carcinoma: A Retrospective Study.

Small cell carcinoma of the cervix (SCCC) is rare but extremely aggressive and resistant to current therapies. We herein evaluate the efficacy of bevacizumab, apatinib, and anlotinib in recurrent/metastatic SCCC patients in a real-world setting. Recurrent/metastatic SCCC patients were recruited between January 2013 and July 2020. Baseline characteristics were extracted from medical records, and patients were divided into an anti-angiogenic group and non-anti-angiogenic group. The efficacy of treatments was determined using Response Evaluation Criteria in Solid Tumors (RECIST) 1.1 criteria. Kaplan-Meier analysis was performed for survival analysis. Sixteen patients received anti-angiogenic drugs after tumor recurrence/metastasis; of them, 10 cases received them as first-line treatment, 5 cases as second-line treatment, and 1 case as fourth-line treatment. Another 23 patients received traditional therapies, including surgery, chemotherapy, and radiotherapy. The use of anti-angiogenic drugs in first-line treatment significantly prolonged progression-free survival (PFS) compared to the controls, with a median PFS of 8 months (2-20 months) and 3 months (1-10 months), respectively (P = .025). This trend was also notable in patients who started anti-angiogenic treatment after the second-line recurrence/metastasis. However, there was no benefits for overall survival (OS) in either the 10 first-line cases or all 16 cases (P = .499 and .31, respectively). Both bevacizumab and small molecule drugs (apatinib and anlotinib) presented similar efficacy in SCCC patients. At present, this is the largest cohort study that provides real-world data, showing that anti-angiogenic regimens could significantly prolong PFS in recurrent/metastatic SCCC. Aside from bevacizumab, the novel oral small molecule drugs provide more choices with similar efficacy. These findings warrant further validation in well-designed future studies.

Small Cell and Other Rare Histologic Types of Cervical Cancer.

The goal of this paper was to summarize the recent evidence on rare subtypes of cervical cancer including small-cell carcinoma of the cervix (SCCC), gastric-type adenocarcinoma, and carcinosarcoma. All three cervical cancer subtypes are aggressive with poor treatment response and high recurrence rates. Molecular studies have identified various actionable mutations in both SCCC (PIK3CA, MYC, TP53, PTEN, ARID1A, KRAS, BRCA2) and gastric-type adenocarcinoma (KRAS, ARID1A, PTEN). While there are a limited number of case reports demonstrating a favorable response for recurrent SCCC to immune checkpoint inhibitors, a larger case series failed to show benefit. The checkpoint inhibitors role in gastric-type adenocarcinoma and carcinosarcoma is yet to be determined. Ninety-one percent of SCCC cases show PARP expression, suggesting a possible role for PARP inhibitors; however, this has yet to be examined in future clinical trials. More studies are needed, with a focus on targeted therapies. The role of PARP inhibitors in SCCC is potentially promising, but significant collaboration between centers/groups will be required to achieve this.

The importance of choosing the right strategy to treat small cell carcinoma of the cervix: a comparative analysis of treatments

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.

Neuroendocrine small cell carcinoma of the cervix: A case report.

Merkel cell polyomavirus (MCPyV) has been found in patients with Merkel cell carcinoma and respiratory tract infections. Merkel cell carcinoma is a primary aggressive neuroendocrine carcinoma of the skin. It has been demonstrated that MCPyV can be transmitted during sexual activity and may be present in the oral and anogenital mucosa. The aim of the present study was to evaluate whether MCPyV coexisted with HPV in three cases of neuroendocrine small cell carcinoma of the cervix using PCR and immunohistochemical analysis Three cases of NSC of the cervix were identified in the pathology archives of Parma University (Italy). Of these, two cases were associated with an adenocarcinomatous component. A set of general primers from the L1 region (forward, L1C1 and reverse, L1C2 or L1C2M) was PCR amplified to detect the broad-spectrum DNA of genital HPV. The presence of MCPyV was investigated via immunohistochemistry using a mouse monoclonal antibody against the MCPyV LT antigen and through PCR analysis to separate viral DNA. HPV DNA was present in all three neuroendocrine carcinomas and in the adenocarcinoma component of the two mixed cases. None of the cases were immunoreactive to CM2B4 and did not contain viral DNA in either their neuroendocrine or adenocarcinomatous component. Whilst it is difficult to draw definitive conclusions from such a small sample size, these data suggested that MCPyV does not coexist with HPV in the cervix. However, in the present study, the absence of detectable MCPyV may have been due to the presence of a genotype that was not detected by the primers used in the PCR analysis or by the antibody used for the immunohistochemical study. MCPyV microRNA may also have been present, inhibiting LT expression. Additional studies with larger cohorts and more advanced molecular biology techniques are required to confirm the hypothesis of the current study.

Optimal treatment strategies for small cell carcinoma of the uterine cervix: A retrospective multi-center study (KROG 19-03)

ObjectiveThis multi-institutional study aimed to identify the optimal treatment strategy for small cell carcinoma of the cervix. Study designWe retrospectively collected the medical records of 166 patients diagnosed with small cell carcinoma of the uterine cervix from January 2000 to December 2015 from 13 institutions of the Korean Radiation Oncology Group. After excluding 18 (10.8 %) patients who initially had distant metastasis, the treatment outcomes of 148 patients were analyzed. ResultsAfter a median 46.4 (1.4–231.9) months of follow-up, the 5-year progression-free survival (PFS) and overall survival (OS) rates of all patients were 45.9 % and 63.5 %, respectively. Distant metastasis was the dominant pattern of failure occurring in 67 patients (45.3 %). We stratified the patients according to the primary local treatment: primary surgery (n = 119), primary radiotherapy (RT) (n = 26), and no local treatment group (n = 3). Although the primary RT group had advanced disease (FIGO stage ≧ IIB) more frequently than the primary surgery group (80.8 % vs. 47.9 %), the PFS and OS did not differ between the groups in multivariate analysis. ConclusionDefinitive RT is a reasonable local treatment option for small cell cervical cancer, particularly for advanced cases. Given the high rates of distant relapse, an effective systemic therapy protocol is warranted for small cell cervical cancer patients.

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.

PurposeSmall-cell carcinoma of the cervix (SCCC) is a rare type of cervical cancer. This study aimed to investigate the clinicopathological characteristics and survival as well as the optimal local treatment modalities for SCCC.Patients and MethodsWe retrospectively evaluated the data of patients diagnosed with SCCC between 1988 and 2015 in our institution – those included in the Surveillance, Epidemiology, and End Results (SEER) database and those in the Periodical Database. Kaplan–Meier method and Cox regression proportional hazard methods were used to evaluate overall survival (OS). A nomogram that could predict OS was constructed based on the Cox proportional hazard model.ResultsIn total, 695 patients were included in this study. The 5-year overall survival in FIGO stage I-IIA and IIB-IV patients was 45.7% and 14.4%, respectively (P <0.01). Univariate and multivariate analyses showed that lymph node status (P <0.01) and cancer-directed surgery (P <0.01) were independent prognostic factors for FIGO I-IIA stage patients, and age (P <0.05), tumor size (P <0.01), chemotherapy (P <0.01) and radiation (P <0.01) were independent prognostic factors for FIGO stage IIB-IV patients.ConclusionBetter prognosis was associated with negative lymph node status, no lymphatic vasculature, surgery, and early-stage patients. Furthermore, our data showed that the prognosis and treatment pattern varied depending on the FIGO stage, and that optimal treatment modalities included radical surgery for early-stage SCCC and chemoradiotherapy for advanced-stage SCCC. It is helpful to assess the individual prognosis of SCCC patients and choose personalized treatment modalities.

Clinical prognostic factors and treatment outcomes in patients with small cell carcinoma of the cervix: A single institution-based retrospective study

Clinical prognostic factors and treatment outcomes in patients with small cell carcinoma of the cervix: A single institution-based retrospective study

Postoperative adjuvant radiation improves local control in surgically treated FIGO stage I-II small cell carcinoma of the cervix

ObjectiveTo determine the prognostic effect of adjuvant radiation and clinicopathological variables in surgically treated patients with small cell carcinoma of the cervix (SCCC).MethodsClinical data of SCCC patients with International Federation of Gynaecology and Obstetrics (FIGO) stage I-II underwent radical surgery from May 2000 to August 2014 at Sun Yat-sen Memorial Hospital were retrospectively reviewed. Forty-three patients with SCCC were included to this study. Chi-square test or Fisher’s exact test, Student’s t test or Mann–Whitney U test, Kaplan–Meier method and multivariate analysis of Cox proportional hazards regression were used for statistical analysis. P < 0.05 was considered to be statistically significant.ResultsAmong 43 patients (median age, 49 years old) recruited, 25(58.1%) had stage I, 18(41.9%) had stage II disease. The 5-year overall survival (OS) rate was 39.54%, and the 5-year disease free survival (DFS) was 27.91%. Distant metastasis was the main cause of treatment failure (71.9%). Patients with adjuvant chemoradiation displayed lower rate of local recurrence than those with adjuvant chemotherapy (10.7% vs 60.0%, P < 0.0001). Multivariable analysis identified lymph node metastasis as a significant prognostic factor for both DFS and OS (P = 0.001, 0.004 respectively). Age was also an independent predictor of OS (P = 0.004). Adjuvant radiation appeared to significantly improve DFS (HR = 0.383, 95% CI, 0.185–0.791), but not OS.ConclusionsAdjuvant radiotherapy could improve the local control and prolong DFS in surgically treated SCCC. However, a large prospective clinical trial is needed to confirm this.

Small Cell Carcinoma of the Cervix: A Retrospective Clinicopathologic Analysis Over a Period of 3 Years in a Referral Laboratory in India

Small cell neuroendocrine carcinoma of the cervix is rare, constituting less than 2% of all invasive cervical malignancies. It has a poor prognosis due to aggressive clinical course with high propensity for nodal and distant metastasis leading to mortality. Although it is known to be a chemosensitive tumor, till date no definite treatment modality has been entirely successful. Six cases diagnosed as small cell carcinoma of cervix over a period of 3 years were included in the study. Formalin-fixed paraffin-embedded tissue was subjected to hematoxylin and eosin (H&E) staining and microscopic examination. This was followed by a panel of immunohistochemical markers including synaptophysin, chromogranin, non-specific enolase (NSE), cytokeratin (CK), CD56 and Ki67 essential for diagnosis. The clinical and morphological profile in all the cases was then evaluated. Out of total 265 cervical malignancies reported, six cases (2.3%) were diagnosed as small cell carcinoma. The median age at the time of diagnosis was 49 years (range 28–67 years). All patients presented with irregular vaginal bleeding, with or without lower abdominal pain. Radiological scans revealed a mass in the cervix. Histopathological examination revealed a tumor arranged in diffuse sheets exhibiting high N/C ratio and stippled chromatin. Immunohistochemical markers employed were positive for CK, synaptophysin, chromogranin and NSE and negative for p40, CK5/6 and CD45 in all the cases. Small cell carcinoma of cervix is a rare malignancy. Because of the high rates of nodal involvement even with early-stage disease, multimodality treatment with radiotherapy and chemotherapy should be considered.

348P - Phase I study of liposomal formulation of eribulin (E7389-LF) in patients (pts) with advanced solid tumours: Primary results of dose-escalation part

BackgroundEribulin is approved for treatment of advanced/metastatic breast cancer and previously treated, unresected liposarcoma. E7389-LF is a liposomal formulation of eribulin. The maximum tolerated dose (MTD) in a prior phase 1 study was 1.4mg/m2 Q3W or 1.5mg/m2 Q2W. MethodsThe primary objective was to determine MTD and compare the tolerability of higher (> prior) Q3W doses vs the prior Q2W dose. E7389-LF was administered (3+3 design) intravenously Q3W (day 1 of a 21-day cycle) and Q2W (days 1 and 15 of a 28-day cycle) to solid tumor pts in Japan for which no alternative standard or effective therapy exists. Planned dose ranges were 1.0-2.5mg/m2 Q3W and 1.0-1.5mg/m2 Q2W. Results21 pts were enrolled; 3, 3 and 6 pts in 1.0, 1.5 and 2.0mg/m2 Q3W; 3 and 6 pts in 1.0 and 1.5mg/m2 Q2W, respectively. 10 pts were male, median age was 58 years (range, 22-68), and 11 had ECOG-PS 0. One dose-limiting toxicity was observed in the 2.0mg/m2 Q3W group (febrile neutropenia; n=6); thus, 2.5mg/m2 Q3W was not assessed. Adverse events ≥ grade 3 included neutropenia (67%), leukopenia (48%), anemia (19%), increased ɣ-glutamyltransferase, lymphopenia, and thrombocytopenia (each 14%). The MTDs were 2.0mg/m2 Q3W and 1.5mg/m2 Q2W. Partial response was noted in 4 pts (19%) with esophageal squamous cell carcinoma, adenoid cystic carcinoma, urothelial cancer, and small cell carcinoma of the cervix. Area-under-the-curve (AUC) values of total eribulin were higher and AUC of unbound eribulin in plasma lower with E7389-LF vs the standard dose of eribulin (Table).Table348PTableEribulin formulation/dosePlasma AUC (h*ng/mL) of eribulinTotalUnboundE7389-LF 1.0mg/m22630098.1E7389-LF 1.5mg/m234700120E7389-LF 2.0mg/m239100148Standard eribulin 1.4mg/m2673336 ConclusionsE7389-LF was well tolerated in Japanese pts with advanced solid tumors with antitumor effects in several tumor types. Plasma AUC of eribulin after administration of E7389-LF suggested a promising exposure profile of the liposomal formulation in humans. The 2.0mg/m2 Q3W regimen was recommended for further investigation in an expansion cohort of specific tumor types. Clinical trial identificationNCT03207672. Legal entity responsible for the studyEisai Co., Ltd. FundingEisai Co., Ltd. DisclosureN. Yamamoto: Research grant / Funding (institution): Chugai, Taiho, Eisai, Lilly, Quintiles, Astellas, BMS, Novartis, Daiichi-Sankyo, Pfizer, Boehringer Ingelheim, Kyowa-Hakko Kirin, ONO Pharmaceutical Co. LTD, Takeda, Janssen Pharma, MSD, Merck; Honoraria (self): ONO Pharmaceutical Co. LTD, Chugai, AstraZeneca, Pfizer, Lilly, BMS; Advisory / Consultancy: Eisai, Otsuka, Takeda, Boehringer Ingelheim, Cimic. S. Iwasa: Research grant / Funding (institution), grants from Eisai, during the conduct of the study: Eisai, Eli Lilly, Chugai, Novartis, Merck-Serono, Daiichi-Sankyo, Bristol-Myers Squibb, Bayer; Honoraria (self), Research grant / Funding (institution), Travel / Accommodation / Expenses: Eli Lilly, Taiho, Chugai, ONO Pharmaceutical Co., LTD. A. Shimomura: Travel / Accommodation / Expenses, personal fees: Chugai; Travel / Accommodation / Expenses, personal fees: Novartis; Travel / Accommodation / Expenses, personal fees: Pfizer; Travel / Accommodation / Expenses, personal fees: Nippon Kayaku; Travel / Accommodation / Expenses, personal fees: AstraZeneca; Travel / Accommodation / Expenses, personal fees: Eisai. S. Kondo: Research grant / Funding (institution): ASLAN Pharmaceuticals; Research grant / Funding (institution): AstraZeneca; Research grant / Funding (institution): Bayer; Research grant / Funding (institution): Eli Lilly; Research grant / Funding (institution): MSD; Research grant / Funding (institution): Pfizer. K. Yonemori: Research grant / Funding (self), trail management at site: Eisai; Honoraria (self): Eisai. Y. Fujiwara: Research grant / Funding (institution): Abbvie, AstraZeneca, BMS, Chugai, Daiichi-Sankyo, Eisai, Eli Lilly, Incyte, Merck Serono, Novartis; Speaker Bureau / Expert testimony, Travel / Accommodation / Expenses: Taiho, Sysmex, ONO, Novartis, MSD, Chugai, BMS, AstraZeneca; Advisory / Consultancy: MSD, ONO, AstraZeneca, BMS. T. Shimizu: Research grant / Funding (institution): Novartis, Eli Lilly, Bristol-Myers Squibb, Daiichi-Sankyo, Millenium-Takeda, AbbVie, AstraZeneca, Eisai, PharmaMar, 3D-Medicine, Symbio Pharmaceuticals, Chordia Therapeutics, Five Prime; Advisory / Consultancy: The Consortium on Harmonization of Institutional Requirements for Clinical Research (CHAIR) Joint Scientific Committee Review Member for Phase 1 trials in Hong Kong. All other authors have declared no conflicts of interest.

Should Small Cell Carcinoma of the Cervix be Treated As Localized Small Cell Cancer or Advanced Cervical Cancer: A Retrospective Multi-Institutional Cohort Study

Should Small Cell Carcinoma of the Cervix be Treated As Localized Small Cell Cancer or Advanced Cervical Cancer: A Retrospective Multi-Institutional Cohort Study

Patterns of Care and Outcomes for Small Cell Carcinoma of the Cervix: A National Retrospective Analysis of 542 Cases

PurposeSmall cell carcinoma of the cervix (SCCC) represents 1% to 5% of cervical cancers, with limited data on management and outcomes. We evaluated patterns of care and outcomes for SCCC using the National Cancer Database. Methods and MaterialsThis retrospective cohort study of SCCC (2004-2011) included 542 cases. Patient demographic, diagnosis, treatment information, and overall survival (OS) were compared with descriptive statistics, logistic regression, Kaplan-Meier, and Cox models. Clinical reasoning was used to select variables for multivariable models to avoid overfitting. ResultsSCCC had more comorbidities, higher grade, and advanced stage than other histologies. SCCC received neoadjuvant chemotherapy (36%) more often than squamous cell carcinoma (23%) and adenocarcinoma (13%, P < .001). SCCC had worse OS across all stages (P < .001). Looking at SCCC alone, patients who received chemoradiation (CRT) (with external beam and brachytherapy) and those who received chemotherapy and surgery (without RT) had similar OS (median OS 44 vs 47 months; P = .7) on Kaplan-Meier. Patients receiving CRT were more likely to have stage II or III and N+ disease (P < .001). When evaluating chemoradiation, the addition of brachytherapy resulted in improved median OS (35 vs 19 months; P = .001) regardless of surgical resection status and controlling for age and stage. Even after controlling for stage, age, and comorbidities, the addition of brachytherapy was associated with a 40% improvement in OS (hazard ratio 1.4, 95% confidence interval 1.0-2.0). ConclusionsSCCC patients benefit from chemotherapy with aggressive local treatment. Patients who receive CRT that included brachytherapy did as well as patients who received chemotherapy followed by surgery. Brachytherapy remains an essential component in the treatment of SCCC with CRT.

Two cases of recurrent small-cell carcinoma of the uterine cervix treated with amrubicin as salvage chemotherapy

Small-cell carcinoma of the cervix (SCCC) is a rare and aggressive tumor; however, no definitive treatment guidelines for SCCC exist. A review of case series revealed that the most frequently used first-line chemotherapy regimen is combination etoposide and cisplatin, which is also used for small-cell lung cancer (SCLC). For recurrent SCLC, the utility of amrubicin (AMR) has recently been reported. However, optimal second-line chemotherapy for recurrent SCCC has remained unclear. Herein the authors report their experience using AMR as salvage chemotherapy for two patients with recurrent SCCC. AMR resulted in disease stabilization in both patients, with relatively long progression-free survival (PFS) of five and 14 months for platinum-refractory and -sensitive disease, respectively. No severe (grade &gt;3) hematological or non-hematological toxicities were observed. In conclusion, AMR may be as effective and safe for recurrent SCCC as it is for recurrent SCLC. To further evaluate the efficacy and safety of AMR for recurrent SCCC, it is necessary to collect additional case studies or conduct a phase II trial.

Small Cell Carcinoma of the Cervix: About Two Cases and Literature Review

Small Cell Carcinoma of the Cervix: About Two Cases and Literature Review

Small cell carcinoma of the cervix: a retrospective analysis of characteristics important in outcomes

To assess clinical characteristics and treatment modalities in patients with small cell carcinoma of the cervix and the effect this has on overall (OS) and recurrence free survival (RFS).

Small Cell Carcinoma of the Cervix: Definitive Chemoradiation for Locally Advanced Disease

Small Cell Carcinoma of the Cervix: Definitive Chemoradiation for Locally Advanced Disease