Adjuvant chemotherapy in stage IB neuroendocrine small cell carcinoma of the cervix

Neuroendocrine small cell carcinoma of the cervix is a very rare and aggressive tumor which tends to metastasize early. This tumor is similar histologically to small cell carcinoma of the lung. Conventional treatment with surgery and/or radiation therapy has not been successful and has prompted the use of adjuvant chemotherapy regimens similar to those used for small cell carcinoma of the lung.

Three patients with Stage IB neuroendocrine small cell carcinoma of the cervix treated with postoperative adjuvant chemotherapy consisting of cisplatinum and VP-16, were identified. Analysis of the outcome of these three patients and a review of the current literature were performed.

Median survival was 28 months. Two patients received pelvic radiation therapy, one due to positive surgical margins and the other due to recurrent disease. Currently two patients are alive and free of disease at 17 and 61 months. The third patient developed hepatic and pelvic recurrence and died 30 months after her presentation and 18 months after recurrence.

The outcome of our three patients and eight similar cases in the literature suggest an improved survival rate with adjuvant chemotherapy compared to conventional treatment with surgery and or radiation therapy.