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

Introduction: Small cell carcinoma of the cervix (SCCC) is relatively uncommon among cervical malignancies and is more likely to develop lymph node and distant metastasis compared to the common squamous histological variant. There is a lack of knowledge about potential prognostic factors, optimal treatment modalities, and survival outcome of SCCC. Aim: The aim of this study is to correlate clinicopathologic parameters and different treatment schedules with survival outcomes of SCCC as progression-free survival (PFS) and overall survival (OS). Materials and Methods: A retrospective study was conducted on diagnosed SCCC patients taking treatment from January 2005 to December 2014. Results: A total of 21 patients were analyzed. The median age of presentation was 47 years. All the patients presented at an advanced stage (IIB-IVB) with high-grade histological differentiation. The median PFS and OS were 5 and 6 months, respectively. The patient receiving multi-agent platinum- and etoposide-based radical concurrent chemoradiotherapy (CCRT) plus brachytherapy had significantly better PFS (P = 0.028) and a trend toward better OS versus other treatment modalities. The median OS was found to be significantly poor in SCCC patients having an additional neuroendocrine component, not receiving brachytherapy after CCRT, and not receiving prophylactic cranial irradiation after radical radiotherapy (P < 0.05). Cisplatinum- plus etoposide-based CCRT schedule had a trend toward better PFS and OS than that of only cisplatinum-based CCRT (P > 0.05). Furthermore, a trend toward better OS was seen for age >40 years, tumor size ≤4 cm, and lymph node-negative status. Relapse was seen in 42.9% of the cases over a 7-month median follow-up. Conclusions: CCRT using multi-agent platinum- plus etoposide-based chemotherapy followed by brachytherapy remains the mainstay of treatment in locally advanced SCCC. The prognostic factors should be considered for customizing treatment.