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Prognostic Factors and Local Treatment Modalities of Small-Cell Carcinoma of the Cervix: An Analysis According to the International Federation of Gynecology and Obstetrics Stage

Authors Huang R, Gan Q, Cheng J

Received 23 January 2020

Accepted for publication 23 April 2020

Published 14 May 2020 Volume 2020:12 Pages 3445—3456


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 4

Editor who approved publication: Dr Sanjeev Srivastava

Ru Huang, Qiyu Gan, Jingxin Cheng

Department of Obstetrics and Gynecology, The Shanghai East Hospital, Shanghai 200120, People’s Republic of China

Correspondence: Jingxin Cheng
Department of Obstetrics and Gynecology, The Shanghai East Hospital, 150 Jimo Avenue, Shanghai 200120, People’s Republic of China
Tel +86 18930937930

Purpose: Small-cell carcinoma of the cervix (SCCC) is a rare type of cervical cancer. This study aimed to investigate the clinicopathological characteristics and survival as well as the optimal local treatment modalities for SCCC.
Patients and Methods: We retrospectively evaluated the data of patients diagnosed with SCCC between 1988 and 2015 in our institution – those included in the Surveillance, Epidemiology, and End Results (SEER) database and those in the Periodical Database. Kaplan–Meier method and Cox regression proportional hazard methods were used to evaluate overall survival (OS). A nomogram that could predict OS was constructed based on the Cox proportional hazard model.
Results: In total, 695 patients were included in this study. The 5-year overall survival in FIGO stage I-IIA and IIB-IV patients was 45.7% and 14.4%, respectively (P < 0.01). Univariate and multivariate analyses showed that lymph node status (P < 0.01) and cancer-directed surgery (P < 0.01) were independent prognostic factors for FIGO I-IIA stage patients, and age (P < 0.05), tumor size (P < 0.01), chemotherapy (P < 0.01) and radiation (P < 0.01) were independent prognostic factors for FIGO stage IIB-IV patients.
Conclusion: Better prognosis was associated with negative lymph node status, no lymphatic vasculature, surgery, and early-stage patients. Furthermore, our data showed that the prognosis and treatment pattern varied depending on the FIGO stage, and that optimal treatment modalities included radical surgery for early-stage SCCC and chemoradiotherapy for advanced-stage SCCC. It is helpful to assess the individual prognosis of SCCC patients and choose personalized treatment modalities.

Keywords: treatment modalities, prognosis, C-index, COX risk regression model, nomogram

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