In a retrospective registry study reported in The Lancet Oncology, Chu et al found that receipt of surgery was associated with improved overall survival in patients with small cell carcinoma of the cervix compared to no surgery.
Study Details
The study involved data from the SEER (Surveillance, Epidemiology, and End Results) 18 registries cohort of patients diagnosed with cervical small cell carcinoma between January 2000 and December 2018 and from a Chinese multi-institutional registry cohort of patients diagnosed with the malignancy between June 2006 and April 2022. The primary outcome measure was overall survival.
Key Findings
A total of 1,288 patients were included in the analysis, consisting of 610 in the SEER cohort and 678 in the Chinese cohort. A total of 40% of patients in the SEER cohort and 85% of the Chinese cohort underwent surgery.
On multivariate analysis, receipt of surgery vs no surgery was associated with improved overall survival in the SEER cohort (hazard ratio [HR] = 0.65, 95% confidence interval [CI] = 0.48–0.88, P = .0058) and in the Chinese cohort (HR = 0.53, 95% CI = 0.37–0.76, P = .0005).
Locally advanced disease was present in 37% of the SEER cohort and 49% of the Chinese cohort. Receipt of surgery was associated with improved overall survival in patients with locally advanced disease in the SEER cohort (HR = 0.61, 95% CI = 0.39–0.94, P = .024) and in the Chinese cohort (HR = 0.59, 95% CI = 0.37–0.95, P = .029). In a propensity score–matching analysis in the SEER cohort (72 patient pairs), surgery was associated with improved overall survival (HR = 0.52, 95% CI = 0.32–0.84, P = .0077).
In multivariate analysis among patients with stage IB3 to IIA2 disease in the Chinese cohort, surgery was associated with improved overall survival (HR = 0.17, 95% CI = 0.05–0.50, P = .0015).
The investigators concluded, “This study provides evidence that surgery improves outcomes of patients with small cell carcinoma of the cervix. Although guidelines recommend nonsurgical methods as first-line treatment, patients with locally advanced disease or stage IB3 [to] IIA2 cancer might benefit from surgery.”
Peng Wu, PhD, of the Department of Gynecology and Obstetrics, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China, is the corresponding author for The Lancet Oncology article.
Disclosure: The study was funded by The National Key R&D Program of China and National Natural Science Foundation of China. For full disclosures of the study authors, visit thelancet.com.
