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Abstract
Objective: This multi-institutional study aimed to identify the optimal treatment strategy for small cell carcinoma of the cervix.

Study design: We retrospectively collected the medical records of 166 patients diagnosed with small cell carcinoma of the uterine cervix from January 2000 to December 2015 from 13 institutions of the Korean Radiation Oncology Group. After excluding 18 (10.8 %) patients who initially had distant metastasis, the treatment outcomes of 148 patients were analyzed.

Results: After a median 46.4 (1.4-231.9) months of follow-up, the 5-year progression-free survival (PFS) and overall survival (OS) rates of all patients were 45.9 % and 63.5 %, respectively. Distant metastasis was the dominant pattern of failure occurring in 67 patients (45.3 %). We stratified the patients according to the primary local treatment: primary surgery (n = 119), primary radiotherapy (RT) (n = 26), and no local treatment group (n = 3). Although the primary RT group had advanced disease (FIGO stage ≧ IIB) more frequently than the primary surgery group (80.8 % vs. 47.9 %), the PFS and OS did not differ between the groups in multivariate analysis.

Conclusion: Definitive RT is a reasonable local treatment option for small cell cervical cancer, particularly for advanced cases. Given the high rates of distant relapse, an effective systemic therapy protocol is warranted for small cell cervical cancer patients.

Affiliations

Won Kyung Cho  1 , Won Park  2 , Young Seok Kim  3 , Hyun-Cheol Kang  4 , Jin Hee Kim  5 , Kyung Su Kim  6 , Kyu Hye Choi  7 , Sei Kyung Chang  8 , Ki Jung Ahn  9 , Seok Ho Lee  10 , Sunghyun Kim  11 , Juree Kim  12 , Keun-Yong Eom  13 , Jeongshim Lee  14 , Jong Hoon Lee  15 , Jin Hwa Choi  16
1 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
2 Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. Electronic address: wonro.park@samsung.com.
3 Department of Radiation Oncology, Asan Medical Center, Ulsan University School of Medicine, Seoul, Republic of Korea. Electronic address: ysk@amc.seoul.kr.
4 Department of Radiation Oncology, Seoul National University College of Medicine, Seoul, Republic of Korea.
5 Department of Radiation Oncology, Dongsan Medical Center, Keimyung University School of Medicine, Daegu, Republic of Korea.
6 Department of Radiation Oncology, Ewha Womans University School of Medicine, Seoul, Republic of Korea.
7 Department of Radiation Oncology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
8 Department of Radiation Oncology, CHA Bundang Medical Center, CHA University, Seongnam, Republic of Korea.
9 Department of Radiation Oncology, Inje University Busan Paik Hospital, Busan, Republic of Korea.
10 Department of Radiation Oncology, Gil Medical Center, Gachon University College of Medicine, Incheon, Republic of Korea.
11 Department of Radiation Oncology, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Republic of Korea.
12 Department of Radiation Oncology, CHA Medical Center, Cha University, Goyang, Republic of Korea.
13 Department of Radiation Oncology, Seoul National University Bundang Hospital, Seoungnam, Republic of Korea.
14 Department of Radiation Oncology, Inha University Hospital, Incheon, Republic of Korea.
15 Department of Radiation Oncology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
16 Department of Radiation Oncology, Chung-Ang University Hospital, Seoul, Republic of Korea.