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Small cell neuroendocrine carcinoma of the cervix is a rare, aggressive cervical cancer that behaves like small cell lung cancer, spreading early to nodes and distant organs even when the tumour is small. Fewer than four in ten women with early disease are alive at five years, and treatment combines the cervical cancer approach with the chemotherapy used for small cell lung cancer.
The WHO classification of female genital tumours lists small cell neuroendocrine carcinoma among the neuroendocrine carcinomas of the cervix, HPV-associated in most cases (usually HPV18). The Gynecologic Cancer InterGroup consensus review describes it as a rare histological entity with a poor outcome because of the high incidence of nodal or distant metastasis even in early stage, and reviews epidemiology, pathology and initial treatment (GCIG 2014). In 188 patients (136 from the literature and 52 from four hospitals), 135 had stage I to IIA, 45 stage IIB to IVA and 8 stage IVB disease; 55.3 percent had surgery, 16.0 percent chemoradiation, 12.8 percent radiation and 3.2 percent chemotherapy alone; five-year disease-specific survival was 36.8 percent for stage I to IIA, 9.8 percent for IIB to IVA and 0 percent for IVB, and adjuvant chemotherapy or chemoradiation was associated with higher survival (Am J Obstet Gynecol 2010).
How it differs from its parent: it is the cervical cancer in which systemic chemotherapy is part of treatment at every stage, in which brain imaging and prophylaxis are considered, and in which surgery alone is never enough.
How common: no registry share in the sources read; rare.
Treatment: radical hysterectomy or chemoradiation according to stage, always with platinum and etoposide chemotherapy as for small cell lung cancer; checkpoint inhibitors with chemotherapy are used by analogy with extensive-stage small cell lung cancer, following the extrapulmonary neuroendocrine carcinoma page (GCIG 2014; Am J Obstet Gynecol 2010).
A rare histological entity of cervical cancer (GCIG 2014); the largest pooled analysis holds 188 patients, 135 with stage I to IIA disease (Am J Obstet Gynecol 2010). No registry share is in the sources read.
Most high-grade ovarian cancers begin at the tip of the fallopian tube; endometrial cancer lines the uterus, cervical cancer starts at the transformation zone; each drains to a different node group.
Same organ: Adenosquamous carcinoma of the cervix, Bartholin gland carcinoma, Vulvar melanoma, Vaginal melanoma, High-grade serous ovarian cancer, Low-grade serous ovarian cancer, Clear cell ovarian cancer, Mucinous ovarian cancer, Adult granulosa cell tumour of the ovary, Ovarian cancer, Endometrial cancer, Cervical cancer, Vulvar cancer, Gestational trophoblastic neoplasia, Uterine sarcoma, Vaginal cancer, POLE-ultramutated endometrial cancer, Mismatch-repair-deficient endometrial cancer, p53-abnormal endometrial cancer, including uterine serous carcinoma, Endometrial cancer with no specific molecular profile, Advanced or recurrent endometrial cancer, Uterine carcinosarcoma, Early cervical cancer and fertility-sparing surgery, Locally advanced cervical cancer, Recurrent or metastatic cervical cancer, Platinum-sensitive ovarian cancer, Platinum-resistant ovarian cancer, HPV-associated vulvar squamous cell carcinoma, HPV-independent vulvar squamous cell carcinoma (p53-mutant), Vaginal squamous cell carcinoma (HPV-associated), Vaginal adenocarcinoma (including DES-associated clear cell adenocarcinoma), Low-risk gestational trophoblastic neoplasia (FIGO score 0 to 6), High-risk gestational trophoblastic neoplasia (FIGO score 7 or more, including ultra-high-risk), Placental-site trophoblastic tumour and epithelioid trophoblastic tumour
Surgery or chemoradiation by stage, always with platinum and etoposide as for small cell lung cancer; checkpoint inhibitors by analogy with extensive-stage small cell lung cancer.
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Query for this cancer: (TITLE:"Small cell neuroendocrine carcinoma of the cervix" OR ABSTRACT:"Small cell neuroendocrine carcinoma of the cervix" OR TITLE:"Small cell carcinoma of the cervix" OR ABSTRACT:"Small cell carcinoma of the cervix" OR TITLE:"Neuroendocrine carcinoma" OR ABSTRACT:"Neuroendocrine carcinoma" OR TITLE:"Neuroendocrine carcinoma rare; SCLC-like" OR ABSTRACT:"Neuroendocrine carcinoma rare; SCLC-like" OR TITLE:"SCCC" OR ABSTRACT:"SCCC") AND (treatment OR therapy OR trial OR survival OR diagnosis). Results are unfiltered search hits about Small cell neuroendocrine carcinoma of the cervix, not a curated reading list.
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Bleeding that will not stop, black or bloody stools, or unexplained bruising when platelets are expected to be low.
Persistent headache with extreme tiredness, nausea, dizziness on standing or low blood pressure. Vomiting, severe weakness or collapse is adrenal crisis.
Dose reduce or avoid for CrCl below 60 (carboplatin is the alternative).
Reduce to 75% for CrCl 15-50.
See all on the product pages:AtezolizumabCisplatinEtoposide·Printable cards in the navigator
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