title: Small cell carcinoma of the cervix: treatment and survival outcomes of 188 patients.
abstract: OBJECTIVE
  To determine the clinicopathologic factors associated with survival in neuroendocrine small cell cervical cancer patients.
  
  
  METHODS
  Patients were identified from a review of literature with an additional 52 patients from four hospitals. Kaplan-Meier and Cox regression methods were used for analyses.
  
  
  RESULTS
  Of 188 patients, 135 had stages I-IIA, 45 stages IIB-IVA, and 8 stage IVB disease. A total of 55.3% underwent surgery, 16.0% had chemoradiation, 12.8% radiation, and 3.2% chemotherapy alone. The 5-year disease-specific survival in stage I-IIA, IIB-IVA, and IVB disease was 36.8%, 9.8%, and 0%, respectively (P < .001). Adjuvant chemotherapy or chemoradiation was associated with improved survival in patients with stages IIB-IVA disease compared with those who did not receive chemotherapy (17.8% vs 6.0%; P = .04). On multivariable analysis, early-stage disease and use of chemotherapy or chemoradiation were independent prognostic factors for improved survival.
  
  
  CONCLUSIONS
  Use of adjuvant chemotherapy or chemoradiation was associated with higher survival in small cell cervical cancer patients.
authors.affiliation: Division of Gynecologic Oncology, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, San Francisco, CA, USA.
authors.forename: Joshua G
authors.initials: JG
authors.lastname: Cohen
authors.forename: Daniel S
authors.initials: DS
authors.lastname: Kapp
authors.forename: Jacob Y
authors.initials: JY
authors.lastname: Shin
authors.forename: Renata
authors.initials: R
authors.lastname: Urban
authors.forename: Alexander E
authors.initials: AE
authors.lastname: Sherman
authors.forename: Lee-may
authors.initials: LM
authors.lastname: Chen
authors.forename: Kathryn
authors.initials: K
authors.lastname: Osann
authors.forename: John K
authors.initials: JK
authors.lastname: Chan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000970:Antineoplastic Agents / Q000627:therapeutic use; D018288:Carcinoma, Small Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D017024:Chemotherapy, Adjuvant; D002945:Cisplatin / Q000627:therapeutic use; D005047:Etoposide / Q000627:therapeutic use; D005260:Female; D006801:Humans; D007044:Hysterectomy; D053208:Kaplan-Meier Estimate; D008197:Lymph Node Excision; D008207:Lymphatic Metastasis; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D018714:Radiotherapy, Adjuvant; D012042:Registries; D002583:Uterine Cervical Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*
chemical_list: D000970:Antineoplastic Agents; D005047:Etoposide; D002945:Cisplatin