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5 slides generated from the cancer page, with a quiz from the open benchmark and speaker notes that cite the sources. Arrow keys move between slides; Print gives one slide per page.
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.
| Setting | Approach | Guideline |
|---|---|---|
| All stages | 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. | not mapped |