Small Cell Cervical Cancer Usually Has Poor Prognosis

NEW YORK JUN 26, 2008 (Reuters Health) - Small cell carcinoma of the cervix is rare compared to other cervical cancers, but the outlook for patients with this disease is poor, Utah-based researchers report in the June issue of Obstetrics and Gynecology.

Dr. Jergin Chen and colleagues at Huntsman Cancer Institute in Salt Lake City note that while recent decades have brought advances in screening and treatment of cervical cancer, most reported series of the unusual small cell cancers have been small and prognostic factors have been unclear.

To investigate further, the researchers examined data from 1997 to 2003 on women with cervical cancers: 290 women with small cell carcinoma, 5231 with adenocarcinoma, and 27,527 with squamous cell carcinoma.

The corresponding mean annual incidences per 100,000 women were 0.06, 1.2 and 6.6. Five-year survival was 35.7% in small cell cancer, 69.7% in adenocarcinoma and 60.5% in squamous cell carcinoma.

There was no improvement in survival over time in those with small cell cancer, although there was a trend toward reduced mortality in the other groups.

Multivariate analysis showed age, stage, race and treatment with hysterectomy alone were significant prognostic indicators of survival in women with small cell carcinoma.

The investigators also found that patients present with more advanced disease and have higher rates of nodal and distant metastasis compared with the other cancers.

"Because of the high rates of nodal involvement even at early stages," the team concludes, "adjuvant chemotherapy and pelvic radiotherapy should be strongly considered."

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