Small cell neuroendocrine carcinoma of uterine cervix: The Scottish experience

15026 Background: Small cell neuroendocrine carcinoma (SCC) of uterine cervix is a rare sub-type of cervical cancer. We report the results of a retrospective analysis of data from 2 Scottish centres of cases of SCC of cervix. The aim is to examine therapeutic interventions, relapse patterns and survival. Methods: Eligible cases were patients (pts) with cervical SCC presented for management discussion between 1995 and 2005 in the 2 scottish centres. Pathology was reviewed centrally by the network pathologists. We reviewed pts case records for staging information, therapeutic interventions, median time to relapse, salvage therapy and responses and overall survival. Results: A total of 21 pts were eligible for the analysis (Glasgow-13 and Aberdeen-8). The median age of the pts was 33 (Range 22–74). Nine pts were FIGO stage 1B, 3 were 2A and 4 were 2B, 3 were 3B and 2 with metastatic disease. Surgery was done in 13 pts [11-radical hysterectomy/pelvic lymphadenectomy, 1-radical hyseterctomy and 1-total abdominal hysterectomy]. Chemotherapy was given to 16 pts [Neo-adjuvant-6, Adjuvant-9, Concurrent-3]. Fourteen pts received combination chemotherapy containing Platinum and Etoposide [EP-2, CE-8, ICE-1 and ACE-3]. One received non-platinum combination. Fourteen pts received radiotherapy [10-Pelvic radiotherapy and brachytherapy, 3-Pelvic only, 1-Brachytherapy only, 2-PCI]. Two pts died of progressive disease shortly after diagnosis without any specific anti-cancer treatment, two pts were disease free after a follow up of 40 and 53 months respectively and one was lost to follow up 7 yrs after diagnosis. Median relapse free survival (RFS) was 16 months. Two year RFS was 25%. The sites of relapse were as follows: Liver-4, Chest-4, Para-aortic-4, Brain-3, Neck-3, Local-2, Abdomen-1. Twelve pts received salvage therapy after relapse [5-responded, 2-not assessed and 5-progressed]. Seven pts were alive after a median follow up of 40 months [Range 17–90]. Median survival was 28 months and the three year overall survival was 45%. Conclusions: We have shown here that with combination treatment SCC can be effectively managed with occasional durable remissions. The overall survival at 3 years was 45%. We believe this was the result of aggressive combination therapy of surgery, chemo and radiotherapy. No significant financial relationships to disclose.