Elsevier

Clinical Oncology

Volume 12, Issue 6, December 2000, Pages 357-362
Clinical Oncology

Case Report
Neuroendocrine Small Cell Carcinoma of the Uterine Cervix: What Disease? What Treatment? Report of Ten Cases and a Review of the Literature

https://doi.org/10.1053/clon.2000.9194Get rights and content

Abstract

Neuroendocrine small cell carcinoma of the uterine cervix (NESCCC) is an entity with very aggressive behaviour. The optimal initial therapeutic approach to this rare disease has not yet been clearly defined.

We reviewed our experience of this disease over the past 10 years with regard to chemosensitivity. Since 1988, ten patients (mean age 33 years; range 24–47) have been diagnosed with NESCCC and treated in our institutions. Disease stage at presentation was IA (one), IB (five, two with lymph node involvement), IIB (one), IIIB (one), and IV (two). One patient had metastatic disease at presentation; three developed metastases during initial treatment. Eight patients underwent surgery and eight received radiation therapy. Six patients received pre- or postoperative cisplatinumvepeside (PE) combination chemotherapy, either alone or concurrently with radiation therapy. PE alone as primary chemotherapy led to disease stabilization in the two patients so treated; concurrent PE and radiation therapy resulted in a pathological complete response in one patient. Eight patients relapsed within 16 months and died of their disease within 29 months from the initial diagnosis. Two patients are alive with no evidence of disease at 13 and 53 months.

Our series confirms the previously described very poor prognosis of NESCCC, despite initial aggressive multidisciplinary treatment. It may be that the introduction of chemotherapy, especially combined primary chemoradiotherapy, might allow patients to do a little better, although at the moment there is no good evidence one way or the other.

References (40)

  • M Morris et al.

    Treatment of small cell carcinoma of the cervix with cisplatin, doxorubicin, and etoposide

    Gynecol Oncol

    (1992)
  • KA O'Hanlan et al.

    Adjuvant therapy for neuroendocrine small cell carcinoma of the cervix: review of the literature

    Gynecol Oncol

    (1991)
  • JR Van Nagell et al.

    Small cell carcinoma of the uterine cervix

    Cancer

    (1988)
  • B -U Sevin et al.

    Efficacy of radical hysterectomy as treatment for patients with small cell carcinoma of the cervix

    Cancer

    (1996)
  • RJ Barrett et al.

    Neuroendocrine features in poorly differentiated and undifferentiated carcinomas of the cervix

    Cancer

    (1987)
  • EG Silva et al.

    Small cell carcinoma of the uterine cervix: pathology and prognostic factors

    Surg Pathol

    (1989)
  • J Albores-Saavedra et al.

    Terminology of endocrine tumors of the uterine cervix: results of a workshop sponsored by the College of American Pathologists and the National Cancer Institute

    Arch Pathol Lab Med

    (1997)
  • JR Van Nagell et al.

    Therapeutic implications of patterns of recurrence in cancer of the uterine cervix

    Cancer

    (1989)
  • EE Sheets et al.

    Surgically treated, early-stage neuroendocrine small-cell cervical carcinoma

    Obstet Gynecol

    (1988)
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