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What adjuvant therapy do you recommend for early stage poorly differentiated small cell neuroendocrine carcinoma of the cervix after surgical resection?

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Do you recommend adjuvant therapy for surgically staged early stage poorly differentiated small cell neuroendocrine carcinoma of the cervix?

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2 Answers
Mednet Member
Gynecologic Oncology · John Muir Medical Center
Answered on

As Dr. @Dr. First Last has so eloquently explained, this is a rare and aggressive tumor. Often, what we think is early stage is not early stage at all. I would recommend CT or MRI brain imaging as well as a PET/CT. if there are no distant metastases, then I would offer at least 4, and up to 6 cycles of platinum/etoposide followed by whole pelvic radiation. I think carboplatin is better tolerated by the patients than cisplatin but either one is acceptable. Given the aggressive nature of these tum...

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Mednet MemberInvited Expert
Gynecologic Oncology · Baylor College of Medicine/Dan L Duncan Comprehensive Cancer Center
Answered on

Yes! With neuroendocrine small cell carcinoma, we know patients are at high risk for recurrence, particularly distant metastasis, with most studies reporting long term survival only when surgery is used in combination with adjuvant therapy. In the retrospective analysis performed by Pei et al., PMID 28954697, the use of 5+ cycles of platinum and etoposide was associated with improved 5-year survival. In this retrospective review, the addition of radiation did not significantly improve recurrence...

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