Pei X, et al. - The outcomes and prognostic factors of patients with small cell neuroendocrine carcinoma of the cervix (SCNEC) were investigated in this study. Furthermore, the physicians aimed to determine the effects of adjuvant treatment on survival in patients with FIGO stage I-II SCNEC after radical surgery. Disease failure was experienced by half of stage I-II SCNEC patients within 3 years, and distant metastasis was an outstanding issue. Etoposide plus platinum (EP) regimen for at least 5 cycles improved long-term recurrence-free survival (RFS) after radical surgery. Even in patients with high-risk factors, additional radiation could be unnecessary.

Methods

• The physicians performed a single-institution retrospective analysis in 92 patients who underwent radical surgery for SCNEC.
• They reviewed all clinicopathological variables and treatment strategies.
• They used Kaplan-Meier and Cox regression methods for survival analyses.

Results

• In this study, 43 (46.7%) patients experienced disease recurrence, and distant metastases were documented in 35 (81.4%) patients, during a median follow-up period of 38 months (23.6–52.4).
• For the entire group, the 3-year recurrence-free survival (RFS) was 50.1%.
• The median RFS was 39 months.
• Independent prognostic factors for disease recurrence were lymph node metastasis, positive parametrial extension, and cycles of etoposide plus platinum (EP) which was confirmed by multivariate analysis.
• Adjuvant chemotherapy for at least 5 cycles of EP (EP 5 +, n = 39) was correlated with improved 5-year RFS compared with other treatments (n = 46) (67.6% vs 20.9%, p < 0.001).
• In patients with EP 5 +, additional radiotherapy or concurrent chemoradiation failed to validate further improved RFS.
• This finding was consistent in the subset of patients with high-risk factors (positive lymph nodes or positive parametrium).