Prognostic Factors And Treatment Comparison In Small Cell Neuroendocrine Carcinoma Of The Uterine Cervix In The Surveillance, Epidemiology, And End Results Database.

e18015 Background: The purpose of this study was to evaluate the impact of treatment modality to survival outcome in small cell neuroendocrine carcinoma of the uterine cervix (SCNEC) using the Surveillance Epidemiology and End Results (SEER) database. Methods: We identified patients with SCNEC from the SEER program during 1981 to 2014and analyzed significant factors for cause-specific survival (CSS) and overall (OS) using Kaplan–Meier survival and Cox regression proportional hazard methods. Results: A total of 503 SCNEC patients were identified. The median follow- up time was 31 months. The 5-year cause specific survival and overall survival were 36.6% and 30.6%, respectively. The FIGO stages I to IV distributions were 189(37.6%), 108 (21.4%),95 (18.9%), and 111 patients (22.1%), respectively. Of the patients with known local treatment strategies, 177 patients (45.9%) were treated with radical surgery and 209 (54.1%) patients underwent primary radiotherapy. In multivariate analysis, local treatment strategies were independent prognostic factors for CSS and OS. The 5- year CSS according to radical surgery and primary radiotherapy were 50.0% and 27.9%, respectively (P < 0.001). The 5-year OS in patients received radical surgery and primary radiotherapy were 57.8%, and 29.6%, respectively (P < 0.001). In FIGO stage I SCNEC, patients treated with radical surgery had superior CSS (P = 0.001) and OS (P = 0.003) than those with primary radiotherapy. However, in FIGO stage II and III SCNEC, there are no differences observed in CSS and OS according to different local treatment strategies. The results also observed that the addition of brachytherapy impact OS (P = 0.002) in FIGO stage III SENCE. The 5-year cause specific survival and overall survival of patients with FIGO IV were only 11.7% and 7.1%, respectively. Conclusions: Small cell neuroendocrine carcinoma of the cervix is a rare disease with aggressive clinical behavior. The results suggested that radical surgery is the optimal local treatment for early-stage SCNEC and combining radiation therapy with brachytherapy should be suitable for patients with advanced stage.