Small cell carcinoma of the female genital tract: A single institution experience.

e15540 Background: Small cell carcinomas (SCC) of the female genital tract (FGT) are rare and there is no standard treatment strategy for managing these patients (pts). The objectives of this study are to report the clinical experience and management of pts with SCC of the FGT, treated at the Cross Cancer Institute, Edmonton, AB, Canada from 1982 to 2009. Methods: A retrospective chart review of all pts diagnosed with SCC of the FGT between 1982 and 2009 was undertaken. Data was collected on demographics, clinical and pathological characteristics, and patient outcomes. Results: Twenty-seven pts were identified with primary sites as follows: cervix 16 (59%), endometrium 7 (26%), ovary 3 (11%) and vagina 1 (4%). Median age at diagnosis was 53 years. Seventy-eight percent (21/27) had pure SCC; the rest had mixed histology. Seventy percent (19/27) were positive for at least one neuroendocrine marker. Overall, thirty percent (8/27) had limited stage (LS) disease; Seventy percent (19/27) had extensive disease (ES). Treatment of limited stage pts was 3/8 (38%) concurrent chemotherapy with radiation, 3/8 (38%) surgery, 1/8 (12%) chemotherapy alone and 1/8 (12%) radiation alone. For extensive stage pts, 6/19 (31%) treated with surgery with or without adjuvant chemotherapy, 4/19 (21%) concurrent chemotherapy with radiation, 2/19 (11%) palliative chemotherapy and 7/19 (37%) supportive care only. For relapsing pts brain was the site of first distant recurrence in three pts. Median survival for the entire cohort was 7.4 months (25.9 months for limited stage disease and 4.8 months for extensive; p < .0001). Conclusions: SCC of the FGT tract is aggressive with an overall poor prognosis. There is no standard of care for these pts and they are often treated according to local protocols based on data extrapolated from SCC lung cancer. Incidence of brain metastasis as the site of first relapse is relatively lower in FGT SCC, suggesting unclear benefit to prophylactic cranial irradiation.