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Published in: BMC Cancer 1/2014

Open Access 01-12-2014 | Research article

Analysis of the impact of platinum-based combination chemotherapy in small cell cervical carcinoma: a multicenter retrospective study in Chinese patients

Authors: Long Huang, Ling-Min Liao, An-Wen Liu, Jian-Bing Wu, Xiao-Ling Cheng, Jia-Xin Lin, Min Zheng

Published in: BMC Cancer | Issue 1/2014

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Abstract

Background

Small cell cervical carcinoma (SCCC) is a rare, aggressive tumor with a poor prognosis. However, information in relation to its treatment is scarce due to the limited numbers of patients. The aim of this study was to establish whether platinum-based combination chemotherapy may by beneficial in this patient population.

Methods

We carried out a multicenter, retrospective study comprising of 72 Chinese patients with SCCC. The patients were treated between 1995 and 2010 at Sun Yat-sen Memorial Hospital or the Cancer Center of Sun Yat-Sen University, and at the First Affiliated Hospital of Shantou University Medical College, China.

Results

Of the 72 patients, 46/72 (63.9%) had Federation of Gynecology and Obstetrics (FIGO) stage Ia–Ib2 and 26/72 (36.1%) had stage IIa–IV disease. Surgery was performed in 63/72 (87.5%) patients, 61/72 (84.7%) patients received chemoradiotherapy and 35/72 (48.6%) received radiotherapy. The 3-year overall survival (OS) and disease-free survival (DFS) rates were as follows: Ia (100%, 100%); Ib1 (62%, 57%); Ib2 (53%, 48%); IIa (36%, 23%); IIb (29%, 21%); IIIb (50%, 50%); and IV (0%, 0%), respectively. The estimated 3-year OS and DFS rates in patients who received platinum-based combination chemotherapy (etoposide + cisplatin [EP], or paclitaxel + cisplatin [TP]) as part of their adjuvant treatment were 64.8% and 63.0%, respectively, compared to 25.2% and 22.0% in those who did not (P = 0.0003; P = 0.0003). Univariate analysis showed that platinum-based combination chemotherapy was associated with improved survival compared to other chemotherapy techniques or no chemotherapy (OS: HR = 0.227; 95% CI, 0.099–0.524; P = 0.001; DFS: HR = 0.210; 95% CI, 0.087–0.506; P = 0.001). Multivariate analysis identified FIGO stage, lymphatic metastasis and platinum-based combination chemotherapy as independent prognostic factors for improved survival in patients with SCCC.

Conclusions

Platinum-based combination chemotherapy (with EP or TP) can improve the 3-year survival outcomes in patients with SCCC. Therefore, it should be considered an important component in a future standardized treatment strategy for SCCC.
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Literature
1.
go back to reference Crowder S, Tuller E: Small cell carcinoma of the female genital tract. Semin Oncol. 2007, 34 (1): 57-63. 10.1053/j.seminoncol.2006.10.028.CrossRefPubMed Crowder S, Tuller E: Small cell carcinoma of the female genital tract. Semin Oncol. 2007, 34 (1): 57-63. 10.1053/j.seminoncol.2006.10.028.CrossRefPubMed
2.
go back to reference Chung HH, Jang MJ, Jung KW, Won YJ, Shin HR, Kim JW, Lee HP: Members for gynecologic oncology committee of Korean society of obstetrics and gynecology: cervical cancer incidence and survival in Korea: 1993–2002. Int J Gynecol Cancer. 2006, 16 (5): 1833-1838. 10.1111/j.1525-1438.2006.00708.x.CrossRefPubMed Chung HH, Jang MJ, Jung KW, Won YJ, Shin HR, Kim JW, Lee HP: Members for gynecologic oncology committee of Korean society of obstetrics and gynecology: cervical cancer incidence and survival in Korea: 1993–2002. Int J Gynecol Cancer. 2006, 16 (5): 1833-1838. 10.1111/j.1525-1438.2006.00708.x.CrossRefPubMed
3.
go back to reference Tsunoda S, Jobo T, Arai M, Imai M, Kanai T, Tamura T, Watanabe J, Obokata A, Kuramoto H: Small-cell carcinoma of the uterine cervix: a clinicopathologic study of 11 cases. Int J Gynecol Cancer. 2005, 15 (2): 295-300. 10.1111/j.1525-1438.2005.15219.x.CrossRefPubMed Tsunoda S, Jobo T, Arai M, Imai M, Kanai T, Tamura T, Watanabe J, Obokata A, Kuramoto H: Small-cell carcinoma of the uterine cervix: a clinicopathologic study of 11 cases. Int J Gynecol Cancer. 2005, 15 (2): 295-300. 10.1111/j.1525-1438.2005.15219.x.CrossRefPubMed
4.
go back to reference Sykes AJ, Shanks JH, Davidson SE: Small cell carcinoma of the uterine cervix: a clinicopathological review. Int J Oncol. 1999, 14 (2): 381-386.PubMed Sykes AJ, Shanks JH, Davidson SE: Small cell carcinoma of the uterine cervix: a clinicopathological review. Int J Oncol. 1999, 14 (2): 381-386.PubMed
5.
go back to reference Miller B, Dockter M, el Torky M, Photopulos G: Small cell carcinoma of the cervix: a clinical and flow-cytometric study. Gynecol Oncol. 1991, 42 (1): 27-33. 10.1016/0090-8258(91)90225-T.CrossRefPubMed Miller B, Dockter M, el Torky M, Photopulos G: Small cell carcinoma of the cervix: a clinical and flow-cytometric study. Gynecol Oncol. 1991, 42 (1): 27-33. 10.1016/0090-8258(91)90225-T.CrossRefPubMed
6.
go back to reference Sheets EE, Berman ML, Hrountas CK, Liao SY, DiSaia PJ: Surgically treated, early-stage neuroendocrine small-cell cervical carcinoma. Obstet Gynecol. 1988, 71 (1): 10-14.PubMed Sheets EE, Berman ML, Hrountas CK, Liao SY, DiSaia PJ: Surgically treated, early-stage neuroendocrine small-cell cervical carcinoma. Obstet Gynecol. 1988, 71 (1): 10-14.PubMed
7.
go back to reference Randall ME, Kim JA, Mills SE, Hahn SS, Constable WC: Uncommon variants of cervical carcinoma treated with radical irradiation. A clinicopathologic study of 66 cases. Cancer. 1986, 57 (4): 816-822. 10.1002/1097-0142(19860215)57:4<816::AID-CNCR2820570423>3.0.CO;2-Z.CrossRefPubMed Randall ME, Kim JA, Mills SE, Hahn SS, Constable WC: Uncommon variants of cervical carcinoma treated with radical irradiation. A clinicopathologic study of 66 cases. Cancer. 1986, 57 (4): 816-822. 10.1002/1097-0142(19860215)57:4<816::AID-CNCR2820570423>3.0.CO;2-Z.CrossRefPubMed
8.
go back to reference Albores-Saavedra J, Larraza O, Poucell S, Rodríguez Martínez HA: Carcinoid of the uterine cervix: additional observations on a new tumor entity. Cancer. 1976, 38 (6): 2328-2342. 10.1002/1097-0142(197612)38:6<2328::AID-CNCR2820380620>3.0.CO;2-J.CrossRefPubMed Albores-Saavedra J, Larraza O, Poucell S, Rodríguez Martínez HA: Carcinoid of the uterine cervix: additional observations on a new tumor entity. Cancer. 1976, 38 (6): 2328-2342. 10.1002/1097-0142(197612)38:6<2328::AID-CNCR2820380620>3.0.CO;2-J.CrossRefPubMed
9.
go back to reference Liao LM, Zhang X, Ren YF, Sun XY, Di N, Zhou N, Pan RK, Ma SH, Zhou LX: Chromogranin A (CgA) as poor prognostic factor in patients with small cell carcinoma of the cervix: results of a retrospective study of 293 patients. PLoS One. 2012, 7 (4): e33674-10.1371/journal.pone.0033674.CrossRefPubMedPubMedCentral Liao LM, Zhang X, Ren YF, Sun XY, Di N, Zhou N, Pan RK, Ma SH, Zhou LX: Chromogranin A (CgA) as poor prognostic factor in patients with small cell carcinoma of the cervix: results of a retrospective study of 293 patients. PLoS One. 2012, 7 (4): e33674-10.1371/journal.pone.0033674.CrossRefPubMedPubMedCentral
10.
go back to reference Morris M, Gershenson DM, Eifel P, Silva EG, Mitchell MF, Burke TW, Wharton JT: Treatment of small cell carcinoma of the cervix with cisplatin, doxorubicin, and etoposide. Gynecol Oncol. 1992, 47 (1): 62-65. 10.1016/0090-8258(92)90077-V.CrossRefPubMed Morris M, Gershenson DM, Eifel P, Silva EG, Mitchell MF, Burke TW, Wharton JT: Treatment of small cell carcinoma of the cervix with cisplatin, doxorubicin, and etoposide. Gynecol Oncol. 1992, 47 (1): 62-65. 10.1016/0090-8258(92)90077-V.CrossRefPubMed
11.
go back to reference Stoler MH, Mills SE, Gersell DJ, Walker AN: Small-cell neuroendocrine carcinoma of the cervix. A human papillomavirus type 18-associated cancer. Am J Surg Pathol. 1991, 15 (1): 28-32. 10.1097/00000478-199101000-00003.CrossRefPubMed Stoler MH, Mills SE, Gersell DJ, Walker AN: Small-cell neuroendocrine carcinoma of the cervix. A human papillomavirus type 18-associated cancer. Am J Surg Pathol. 1991, 15 (1): 28-32. 10.1097/00000478-199101000-00003.CrossRefPubMed
12.
go back to reference Cohen JG, Kapp DS, Shin JY, Urban R, Sherman AE, Chen LM, Osann K, Chan JK: Small cell carcinoma of the cervix: treatment and survival outcomes of 188 patients. Am J Obstet Gynecol. 2010, 203 (4): 347.e1-347.e6.CrossRef Cohen JG, Kapp DS, Shin JY, Urban R, Sherman AE, Chen LM, Osann K, Chan JK: Small cell carcinoma of the cervix: treatment and survival outcomes of 188 patients. Am J Obstet Gynecol. 2010, 203 (4): 347.e1-347.e6.CrossRef
13.
go back to reference Chan JK, Loizzi V, Burger RA, Rutgers J, Monk BJ: Prognostic factors in neuroendocrine small cell cervical carcinoma: a multivariate analysis. Cancer. 2003, 97 (3): 568-574. 10.1002/cncr.11086.CrossRefPubMed Chan JK, Loizzi V, Burger RA, Rutgers J, Monk BJ: Prognostic factors in neuroendocrine small cell cervical carcinoma: a multivariate analysis. Cancer. 2003, 97 (3): 568-574. 10.1002/cncr.11086.CrossRefPubMed
14.
go back to reference Abeler VM, Holm R, Nesland JM, Kjørstad KE: Small cell carcinoma of the cervix. A clinicopathologic study of 26 patients. Cancer. 1994, 73 (3): 672-677. 10.1002/1097-0142(19940201)73:3<672::AID-CNCR2820730328>3.0.CO;2-R.CrossRefPubMed Abeler VM, Holm R, Nesland JM, Kjørstad KE: Small cell carcinoma of the cervix. A clinicopathologic study of 26 patients. Cancer. 1994, 73 (3): 672-677. 10.1002/1097-0142(19940201)73:3<672::AID-CNCR2820730328>3.0.CO;2-R.CrossRefPubMed
15.
go back to reference Huang L, Lin JX, Yu YH, Zhang MY, Wang HY, Zheng M: Downregulation of six microRNAs is associated with advanced stage, lymph node metastasis and poor prognosis in small cell carcinoma of the cervix. PLoS One. 2012, 7 (3): e33762-10.1371/journal.pone.0033762.CrossRefPubMedPubMedCentral Huang L, Lin JX, Yu YH, Zhang MY, Wang HY, Zheng M: Downregulation of six microRNAs is associated with advanced stage, lymph node metastasis and poor prognosis in small cell carcinoma of the cervix. PLoS One. 2012, 7 (3): e33762-10.1371/journal.pone.0033762.CrossRefPubMedPubMedCentral
16.
go back to reference Sevin BU, Method MW, Nadji M, Lu Y, Averette HA: Efficacy of radical hysterectomy as treatment for patients with small cell carcinoma of the cervix. Cancer. 1996, 77 (8): 1489-1493. 10.1002/(SICI)1097-0142(19960415)77:8<1489::AID-CNCR10>3.0.CO;2-W.CrossRefPubMed Sevin BU, Method MW, Nadji M, Lu Y, Averette HA: Efficacy of radical hysterectomy as treatment for patients with small cell carcinoma of the cervix. Cancer. 1996, 77 (8): 1489-1493. 10.1002/(SICI)1097-0142(19960415)77:8<1489::AID-CNCR10>3.0.CO;2-W.CrossRefPubMed
17.
go back to reference Gersell DJ, Mazoujian G, Mutch DG, Rudloff MA: Small-cell undifferentiated carcinoma of the cervix. A clinicopathologic, ultrastructural, and immunocytochemical study of 15 cases. Am J Surg Pathol. 1988, 12 (9): 684-698. 10.1097/00000478-198809000-00005.CrossRefPubMed Gersell DJ, Mazoujian G, Mutch DG, Rudloff MA: Small-cell undifferentiated carcinoma of the cervix. A clinicopathologic, ultrastructural, and immunocytochemical study of 15 cases. Am J Surg Pathol. 1988, 12 (9): 684-698. 10.1097/00000478-198809000-00005.CrossRefPubMed
18.
go back to reference Pazdur R, Bonomi P, Slayton R, Gould VE, Miller A, Jao W, Dolan T, Wilbanks G: Neuroendocrine carcinoma of the cervix: implications for staging and therapy. Gynecol Oncol. 1981, 12 (1): 120-128. 10.1016/0090-8258(81)90103-7.CrossRefPubMed Pazdur R, Bonomi P, Slayton R, Gould VE, Miller A, Jao W, Dolan T, Wilbanks G: Neuroendocrine carcinoma of the cervix: implications for staging and therapy. Gynecol Oncol. 1981, 12 (1): 120-128. 10.1016/0090-8258(81)90103-7.CrossRefPubMed
19.
go back to reference Van Nagell JR, Jr Donaldson ES, Wood EG, Maruyama Y, Utley J: Small cell cancer of the uterine cervix. Cancer. 1977, 40 (5): 2243-2249. 10.1002/1097-0142(197711)40:5<2243::AID-CNCR2820400534>3.0.CO;2-H.CrossRefPubMed Van Nagell JR, Jr Donaldson ES, Wood EG, Maruyama Y, Utley J: Small cell cancer of the uterine cervix. Cancer. 1977, 40 (5): 2243-2249. 10.1002/1097-0142(197711)40:5<2243::AID-CNCR2820400534>3.0.CO;2-H.CrossRefPubMed
20.
go back to reference Piver MS, Rutledge F, Smith JP: Five classes of extended hysterectomy for women with cervical cancer. Obstet Gynecol. 1974, 44 (2): 265-272.PubMed Piver MS, Rutledge F, Smith JP: Five classes of extended hysterectomy for women with cervical cancer. Obstet Gynecol. 1974, 44 (2): 265-272.PubMed
21.
go back to reference Kuji S, Hirashima Y, Nakayama H, Nishio S, Otsuki T, Nagamitsu Y, Tanaka N, Ito K, Teramoto N, Yamada T: Diagnosis, clinicopathologic features, treatment, and prognosis of small cell carcinoma of the uterine cervix; Kansai Clinical Oncology Group/Intergroup study in Japan. Gynecol Oncol. 2013, 129 (3): 522-527. 10.1016/j.ygyno.2013.02.025.CrossRefPubMed Kuji S, Hirashima Y, Nakayama H, Nishio S, Otsuki T, Nagamitsu Y, Tanaka N, Ito K, Teramoto N, Yamada T: Diagnosis, clinicopathologic features, treatment, and prognosis of small cell carcinoma of the uterine cervix; Kansai Clinical Oncology Group/Intergroup study in Japan. Gynecol Oncol. 2013, 129 (3): 522-527. 10.1016/j.ygyno.2013.02.025.CrossRefPubMed
22.
go back to reference Tsuchiya R, Suzuki K, Ichinose Y, Watanabe Y, Yasumitsu T, Ishizuka N, Kato H: Phase II trial of postoperative adjuvant cisplatin and etoposide in patients with completely resected stage I-IIIa small cell lung cancer: the Japan Clinical Oncology Lung Cancer Study Group Trial (JCOG9101). J Thorac Cardiovasc Surg. 2005, 129 (5): 977-983. 10.1016/j.jtcvs.2004.05.030.CrossRefPubMed Tsuchiya R, Suzuki K, Ichinose Y, Watanabe Y, Yasumitsu T, Ishizuka N, Kato H: Phase II trial of postoperative adjuvant cisplatin and etoposide in patients with completely resected stage I-IIIa small cell lung cancer: the Japan Clinical Oncology Lung Cancer Study Group Trial (JCOG9101). J Thorac Cardiovasc Surg. 2005, 129 (5): 977-983. 10.1016/j.jtcvs.2004.05.030.CrossRefPubMed
23.
go back to reference Leo F, Pastorino U: Surgery in small-cell lung carcinoma. Where is the rationale?. Semin Surg Oncol. 2003, 21 (3): 176-181. 10.1002/ssu.10035.CrossRefPubMed Leo F, Pastorino U: Surgery in small-cell lung carcinoma. Where is the rationale?. Semin Surg Oncol. 2003, 21 (3): 176-181. 10.1002/ssu.10035.CrossRefPubMed
24.
go back to reference Brock MV, Hooker CM, Syphard JE, Westra W, Xu L, Alberg AJ, Mason D, Baylin SB, Herman JG, Yung RC, Brahmer J, Rudin CM, Ettinger DS, Yang SC: Surgical resection of limited disease small cell lung cancer in the new era of platinum chemotherapy: Its time has come. J Thorac Cardiovasc Surg. 2005, 129 (1): 64-72. 10.1016/j.jtcvs.2004.08.022.CrossRefPubMed Brock MV, Hooker CM, Syphard JE, Westra W, Xu L, Alberg AJ, Mason D, Baylin SB, Herman JG, Yung RC, Brahmer J, Rudin CM, Ettinger DS, Yang SC: Surgical resection of limited disease small cell lung cancer in the new era of platinum chemotherapy: Its time has come. J Thorac Cardiovasc Surg. 2005, 129 (1): 64-72. 10.1016/j.jtcvs.2004.08.022.CrossRefPubMed
25.
go back to reference Hoskins PJ, Swenerton KD, Pike JA, Lim P, Aquino-Parsons C, Wong F, Lee N: Small-cell carcinoma of the cervix: fourteen years of experience at a single institution using a combined-modality regimen of involved-field irradiation and platinum-based combination chemotherapy. J Clin Oncol. 2003, 21 (18): 3495-3501. 10.1200/JCO.2003.01.501.CrossRefPubMed Hoskins PJ, Swenerton KD, Pike JA, Lim P, Aquino-Parsons C, Wong F, Lee N: Small-cell carcinoma of the cervix: fourteen years of experience at a single institution using a combined-modality regimen of involved-field irradiation and platinum-based combination chemotherapy. J Clin Oncol. 2003, 21 (18): 3495-3501. 10.1200/JCO.2003.01.501.CrossRefPubMed
26.
go back to reference Zivanovic O, Leitao MM, Park KJ, Zhao H, Diaz JP, Konner J, Alektiar K, Chi DS, Abu-Rustum NR, Aghajanian C: Small cell neuroendocrine carcinoma of the cervix: Analysis of outcome, recurrence pattern and the impact of platinum-based combination chemotherapy. Gynecol Oncol. 2009, 112 (3): 590-593. 10.1016/j.ygyno.2008.11.010.CrossRefPubMed Zivanovic O, Leitao MM, Park KJ, Zhao H, Diaz JP, Konner J, Alektiar K, Chi DS, Abu-Rustum NR, Aghajanian C: Small cell neuroendocrine carcinoma of the cervix: Analysis of outcome, recurrence pattern and the impact of platinum-based combination chemotherapy. Gynecol Oncol. 2009, 112 (3): 590-593. 10.1016/j.ygyno.2008.11.010.CrossRefPubMed
27.
go back to reference Gardner GJ, Reidy-Lagunes D, Gehrig PA: Neuroendocrine tumors of the gynecologic tract: A Society of Gynecologic Oncology (SGO) clinical document. Gynecol Oncol. 2011, 122 (1): 190-198. 10.1016/j.ygyno.2011.04.011.CrossRefPubMed Gardner GJ, Reidy-Lagunes D, Gehrig PA: Neuroendocrine tumors of the gynecologic tract: A Society of Gynecologic Oncology (SGO) clinical document. Gynecol Oncol. 2011, 122 (1): 190-198. 10.1016/j.ygyno.2011.04.011.CrossRefPubMed
28.
go back to reference Lee JM, Lee KB, Nam JH, Ryu SY, Bae DS, Park JT, Kim SC, Cha SD, Kim KR, Song SY, Kang SB: Prognostic factors in FIGO stage IB-IIA small cell neuroendocrine carcinoma of the uterine cervix treated surgically: results of a multi-center retrospective Korean study. Ann Oncol. 2008, 19 (2): 321-326. 10.1093/annonc/mdm465.CrossRefPubMed Lee JM, Lee KB, Nam JH, Ryu SY, Bae DS, Park JT, Kim SC, Cha SD, Kim KR, Song SY, Kang SB: Prognostic factors in FIGO stage IB-IIA small cell neuroendocrine carcinoma of the uterine cervix treated surgically: results of a multi-center retrospective Korean study. Ann Oncol. 2008, 19 (2): 321-326. 10.1093/annonc/mdm465.CrossRefPubMed
29.
go back to reference Wang KL, Chang TC, Jung SM, Chen CH, Cheng YM, Wu HH, Liou WS, Hsu ST, Ou YC, Yeh LS, Lai HC, Huang CY, Chen TC, Chang CJ, Lai CH: Primary treatment and prognostic factors of small cell neuroendocrine carcinoma of the uterine cervix: a Taiwanese Gynecologic Oncology Group study. Eur J Cancer. 2012, 48 (10): 1484-1494. 10.1016/j.ejca.2011.12.014.CrossRefPubMed Wang KL, Chang TC, Jung SM, Chen CH, Cheng YM, Wu HH, Liou WS, Hsu ST, Ou YC, Yeh LS, Lai HC, Huang CY, Chen TC, Chang CJ, Lai CH: Primary treatment and prognostic factors of small cell neuroendocrine carcinoma of the uterine cervix: a Taiwanese Gynecologic Oncology Group study. Eur J Cancer. 2012, 48 (10): 1484-1494. 10.1016/j.ejca.2011.12.014.CrossRefPubMed
Metadata
Title
Analysis of the impact of platinum-based combination chemotherapy in small cell cervical carcinoma: a multicenter retrospective study in Chinese patients
Authors
Long Huang
Ling-Min Liao
An-Wen Liu
Jian-Bing Wu
Xiao-Ling Cheng
Jia-Xin Lin
Min Zheng
Publication date
01-12-2014
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2014
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-14-140

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