title: Diagnosis, clinicopathologic features, treatment, and prognosis of small cell carcinoma of the uterine cervix; Kansai Clinical Oncology Group/Intergroup study in Japan.
abstract: OBJECTIVE
  This is a multicenter, collaborative study to accumulate cases of small cell carcinoma of the uterine cervix (SmCC), to clarify its clinical and clinicopathologic features and prognosis, and to obtain findings to establish future individualized treatment.
  
  
  METHODS
  At medical centers participating in the Kansai Clinical Oncology Group/Intergroup, patients diagnosed with SmCC between 1997 and 2007 were enrolled. Clinicopathologic features and prognosis were retrospectively evaluated in patients with SmCC diagnosed at a central pathologic review.
  
  
  RESULTS
  A total of 71 patients were registered at 25 medical centers in Japan. Of these, 52 patients (73%) were diagnosed with SmCC based on a pathological review. These 52 patients diagnosed with SmCC were analyzed. The median follow-up period was 57 months. The 4-year progression-free survival (PFS) was: IB1, 59%; IB2, 68%; IIB, 13%; and IIIB, 17%. The 4-year overall survival (OS) was: IB1, 63%; IB2, 67%; IIB, 30%; IIIB, 29%; and IVB, 25%. For postoperative adjuvant therapy, postoperative chemotherapy (a platinum drug in all cases) was compared to non-chemotherapy. The 4-year PFS was 65% and 14%, and the 4-year OS was 65% and 29%. PFS was significantly better (p=0.002), and the OS tended to be better (p=0.073) in the group with postoperative chemotherapy.
  
  
  CONCLUSIONS
  Even in patients with early stage SmCC, the prognosis is poor. However, in early stage patients, by adding postoperative chemotherapy, the prognosis may improve. Currently, various treatment protocols are used at each medical center, but in the future, a standardized treatment protocol for SmCC will hopefully be established.
authors.affiliation: Division of gynecology, Shizuoka Cancer Center Hospital, Sunto-gun, Shizuoka, Japan. s.kuji@scchr.jp
authors.forename: Shiho
authors.initials: S
authors.lastname: Kuji
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Hirashima
authors.forename: Hiroki
authors.initials: H
authors.lastname: Nakayama
authors.forename: Shin
authors.initials: S
authors.lastname: Nishio
authors.forename: Takeo
authors.initials: T
authors.lastname: Otsuki
authors.forename: Yuzo
authors.initials: Y
authors.lastname: Nagamitsu
authors.forename: Naotake
authors.initials: N
authors.lastname: Tanaka
authors.forename: Kimihiko
authors.initials: K
authors.lastname: Ito
authors.forename: Norihiro
authors.initials: N
authors.lastname: Teramoto
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018288:Carcinoma, Small Cell / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007564:Japan; D008875:Middle Aged; D009367:Neoplasm Staging; D057285:Precision Medicine; D012189:Retrospective Studies; D002583:Uterine Cervical Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery / Q000628:therapy*; D055815:Young Adult