Small Cell Carcinoma of Uterine Cervix: A Single-institution Experience

We aimed to analyze the clinical outcome of patients with small cell carcinoma (SmCC) of uterine cervix. We retrospectively reviewed the clinical courses of patients with SmCC of uterine cervix referred to Taipei Veterans General Hospital between 1993 and 2001. Demographic and clinical data were presented and analyzed. Survival analysis was performed by using the Kaplan-Meier method. The statistical significance was determined by the log-rank test. SmCC represented 0.38% of malignancies of uterine cervix in this institution. Nine patients with SmCC of uterine cervix were included in this study. The median age at diagnosis was 45 years (range, 32-77 years). Vaginal bleeding was the most common symptom presented in all our patients. The median duration of the symptoms before diagnosis was 3 months (range, 1-6 months). Three patients were stage IB, two IIA, one IIB, two IIIB, and one IVB by FIGO staging at diagnosis. Five patients underwent radical surgery and adjuvant chemotherapy; two, radical surgery, adjuvant chemotherapy and radiotherapy; one, chemotherapy and radiotherapy; and one, chemotherapy only. With a median follow-up of 28 months, three patients died of this disease, five patients remained alive without disease and the remaining one patient died of a non-cancer related cause. The median overall survival (OS) was not reached and the estimated 5-year survival rate was 66.67%. The median OS was significantly longer in patients with early stage disease (P=0.02). There was no significant difference in median OS between pre-menopausal and menopausal patients (P=0.466). In summary, SmCC of uterine cervix is a relatively rare but aggressive neoplasm with high potential of metastases. Patients with early stage disease had better prognosis. Combined-modality treatment is necessary to achieve the optimal outcome.