OBJECTIVETo study the clinicopathologic characteristics, prognostic factors, response to chemotherapy, chemotherapy-caused disease-free interval and overall survival of small cell carcinoma of uterine cervix (SCCUC).

METHODSTwelve patients with SCCUC were treated from 1995 to 1999, with their clinic ophathologic data retrospectively analyzed. Their stages were I b(1) 2, I b(2) 4, II a 3, II b 1, III b 1 and IV b1. All 12 samples were assessed through immunohistochemical methods including epithelial cell markers and neuroendocrine cell markers, showing positive results in all. Nine early stage patients underwent radical hysterectomy with pelvic lymphadenectomy. Five of these 9 patients had received neoadjuvant chemotherapy (NCH) once or twice before operation, three patients received adjuvant chemotherapy (ACH) once to six times after operation. Three patients with advanced lesions received concurrent chemotherapy twice to four times.

RESULTS44.4% (4/9) of patients treated by pelvic lymphadenectomy showed positive lymph node metastasis. The average disease free intervals of patients who showed positive or negative pelvic lymph node were 16.1 and 25.7 months, overall survival of 19 and 32 months. The success rate of surgery in the NCH group was 100%, 60% of whom showed chemotherapy response pathologically. They showed overall response rates of 80% (4/5), 20% CR (1/5) and 60% PR (3/5).

CONCLUSIONPoor prognosis of small cell carcinoma of uterine cervix, even the early lesions, is due to its high incidence of pelvic lymph metastasis. The risk factor of this lesion is high sensitivity to chemotherapy, but chemotherapeutic long-term survival should be studied further with more allotted material.