Chemotherapy Plus Radiotherapy Versus Radiotherapy in Patients With Small Cell Carcinoma of the Esophagus: A SEER Database Analysis

Background: Small cell carcinoma of the esophagus is a rare malignant tumor. We aimed to explore the chemotherapeutic efficacy on the prognosis of patients with small cell carcinoma of the esophagus who received radiotherapy. Methods: To identify the population of interest, Surveillance, Epidemiology, and End Results data from 1996 to 2016 were chosen. Univariate and multivariate analyses were used to probe into prognosis factors. Multivariate Cox regression analysis was conducted to identify factors related to overall survival and cancer-specific survival. Results: Overall, data from 162 patients were analyzed in this study. Tumor size (P = 0.014), T staging (P = 0.028), and chemotherapy (P < 0.001) were independent prognostic factors affecting overall survival. Patients with regional disease (hazard ratio = 5.435, P < 0.001) and distant metastasis (hazard ratio = 2.183, P < 0.001) who received radiotherapy alone had worse survival than those receiving chemoradiotherapy. Tumor size (P = 0.004) and chemotherapy (P < 0.001) were independent prognostic factors affecting cancer-specific survival. Tumor size was an independent factor affecting cancer-specific survival for patients receiving chemoradiation. Conclusions: Age, T staging, tumor size, primary site, and chemotherapy are independent prognosis factors affecting overall survival and cancer-specific survival in patients with small cell carcinoma of the esophagus who receive radiotherapy. Chemotherapy might further improve cancer-specific survival in patients with small cell carcinoma of the esophagus receiving radiotherapy at all stages.

Download Full-text

Comments on “Treatment Strategies and Prognostic Factors of Limited-Stage Primary Small Cell Carcinoma of the Esophagus”

Journal of Thoracic Oncology ◽

10.1016/j.jtho.2017.10.026 ◽

2018 ◽

Vol 13 (2) ◽

pp. e23-e24 ◽

Cited By ~ 1

Author(s):

Saeid Safiri ◽

Erfan Ayubi ◽

Kamyar Mansori

Keyword(s):

Prognostic Factors ◽

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Treatment Strategies ◽

Small Cell ◽

Carcinoma Of The Esophagus ◽

Limited Stage

Download Full-text

Extrapulmonary small cell carcinoma: Prognostic factors, patterns of care, and overall survival

European Journal of Surgical Oncology ◽

10.1016/j.ejso.2020.04.017 ◽

2020 ◽

Vol 46 (9) ◽

pp. 1596-1604 ◽

Cited By ~ 1

Author(s):

Steven F. Mandish ◽

Jeremy T. Gaskins ◽

Mehran B. Yusuf ◽

Brendan P. Little ◽

Neal E. Dunlap

Keyword(s):

Overall Survival ◽

Prognostic Factors ◽

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Small Cell ◽

Patterns Of Care ◽

Extrapulmonary Small Cell Carcinoma

Download Full-text

Survival outcomes and prognostic factors of primary small cell carcinoma of the esophagus

Journal of Thoracic Disease ◽

10.21037/jtd-20-3334 ◽

2021 ◽

Vol 13 (5) ◽

pp. 2790-2802

Author(s):

Huikai Miao ◽

Rongzhen Li ◽

Dongni Chen ◽

Jia Hu ◽

Youfang Chen ◽

...

Keyword(s):

Prognostic Factors ◽

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Small Cell ◽

Survival Outcomes ◽

Carcinoma Of The Esophagus

Download Full-text

Small Cell Carcinoma Esophagus: Experience of an Indian Tertiary Cancer Center

10.21203/rs.3.rs-621928/v2 ◽

2021 ◽

Author(s):

Goutam Santosh Panda ◽

Vanita Noronha ◽

Subhash Yadav ◽

Amit Joshi ◽

Vijay Patil ◽

...

Keyword(s):

Overall Survival ◽

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Median Overall Survival ◽

Local Therapy ◽

Cranial Irradiation ◽

Small Cell ◽

Cancer Center ◽

Carcinoma Of The Esophagus ◽

Stage Disease

Abstract Background: Small cell carcinoma of the esophagus (SCCE) is a rare and aggressive tumor with no established standard treatment.Methods: This is a retrospective study of adult patients with histologically proven SCCE registered between February 2011 and March 2020 at Tata Memorial Hospital in Mumbai.Results: There were 56 patients with 29(51.8%) having limited-stage disease (LD) and 27(48.2%) having extensive-stage disease (ED). The median age was 58(IQR 51-65) years, 57.1% were men, 40% were smokers. Amongst LD-SCCE patients, 23 underwent local therapy i.e. radiation (19, 65.5%), surgery (4, 13.8%) and 27 received chemotherapy in neoadjuvant (23, 79.3%), concurrent (18, 62.1%) and adjuvant (4,13.8%) settings. Total 19 ED-SCCE patients (70.4%) received chemotherapy. Prophylactic cranial irradiation (PCI) was delivered to 11(37.9%) and 7(25.9%) patients with LD-SCCE and ED-SCCE, respectively. Signiﬁcant grade ≥3 chemo-toxicities in patients with LD-SCCE and ED-SCCE included febrile neutropenia in 33.3% and 23.5%, anemia in 9.5% and 17.6%, and dyselectrolytemia in 14.3% and 11.8%, respectively. The median overall survival (OS) in LD-SCCE and ED-SCCE were 22.9 (95% CI 1.8-44.1) months and 11.8 (95% CI 7.3-16.4) months, respectively. Age <60years (p=0.004) and tumor epicenter in lower third esophagus (p=0.002) were good prognostic factors for OS in LD-SCCE and ED-SCCE patients respectively. The incidence of brain metastasis was low, both at presentation (1/27, 3.7%) and at relapse (5/56, 8.9%).Conclusion: Although the median overall survival of LD-SCCE is better than ED-SCCE, it is still under 2 years. Brain metastases are uncommon and PCI can be avoided with close clinico-radiological follow up.

Download Full-text

Radiotherapy for small cell carcinoma of the esophagus: outcomes and prognostic factors from a retrospective study

Radiation Oncology ◽

10.1186/s13014-019-1415-9 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 1

Author(s):

Baoqing Chen ◽

Han Yang ◽

Huali Ma ◽

Qiaoqiao Li ◽

Bo Qiu ◽

...

Keyword(s):

Prognostic Factors ◽

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Small Cell ◽

Therapeutic Modality ◽

Cancer Center ◽

Lesion Length ◽

Carcinoma Of The Esophagus ◽

Kaplan Meier ◽

Ecog Ps

Abstract Background Small cell carcinoma of the esophagus (SCCE) is characterized by its progressive feature and poor prognosis. There is no consensus on a standard therapeutic modality for SCCE. In this study, we aimed to characterize the outcomes of primary SCCE patients treated by radiation therapy as part of treatment and investigate prognostic factors. Methods We retrospectively analyzed the data of 42 SCCE patients who were treated by RT as part of treatment at the Sun Yat-sen University Cancer Center from 2001 to 2014. The Kaplan-Meier and log-rank method were used to analyze survival. Cox’s hazard regression model was applied to determine prognostic factors. Results Of the 42 enrolled patients, 25 had limited disease (LD) and 17 with extensive disease (ED). The overall response rate (CR + PR) was 60.0% (21/35). The median overall survival time (OS) for whole and LD group were 12.9 and 36.8 months. The 1-, 3- and 5-year OS rates of the whole cohort were 64.9, 31.3, and 13.9%, respectively. OS was significantly longer in patients with ECOG performance score (ECOG PS) < 2 (p = 0.001), lesion length ≤ 5 cm (p = 0.001), and LD (p = 0.049). In the patients with LD, multivariate analysis indicated that combined with chemotherapy (P = 0.046) and higher radiation dose (P = 0.027) predicted better prognosis in OS. The overall rate of grade 3–4 toxicities in the whole cohort was 37.5%. In total, 65% (17/26) patients with recurrent disease died with the metastasis with or without the primary recurrence. Conclusion RT was one of the effective and safe treatments for locoregional control of SCCE. Lower ECOG PS score, shorter lesion length, treated with chemotherapy, and a higher dose of RT were identified as favorable independent prognostic factors.

Download Full-text

A Retrospective Study of 52 Patients With Primary Small Cell Carcinoma of the Esophagus Treated With Radical Surgery

Cancer Control ◽

10.1177/10732748211027147 ◽

2021 ◽

Vol 28 ◽

pp. 107327482110271

Author(s):

Ningbo Fan ◽

Zhen Wang ◽

Yuanheng Huang ◽

Zihui Tan ◽

Han Yang ◽

...

Keyword(s):

Prognostic Factors ◽

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Radical Surgery ◽

Multivariable Analysis ◽

Tumor Location ◽

Small Cell ◽

Thoracic Esophagus ◽

Carcinoma Of The Esophagus ◽

Tumor Length

Background: Primary small cell carcinoma of the esophagus (SCCE) is a rare and extremely fatal disease. We aim to evaluate the efficacy of radical surgery for resectable SCCE and to explore potential prognostic factors. Methods: We retrospectively reviewed 52 consecutive SCCE patients who underwent radical surgery from February 1993 to November 2014 at a single institution. The Kaplan-Meier estimator with log-rank test was used to assess overall survival (OS), disease-free survival (DFS) and median survival time. Univariate and multivariable analyses were used to evaluate prognostic factors through Cox proportional hazard regression model. Results: Twenty-five (48.1%) patients were treated with surgery alone, whereas 27 (51.9%) patients underwent adjuvant therapy after surgery. The median OS time was 17.4 months (95% CI: 13.5-21.3). The median DFS time was 13.4 months (95% CI: 7.7-19.0). Patients whose tumors were located in the lower part of thoracic esophagus and the esophagogastric junction showed significantly better OS (27.0 vs. 13.2 months, P = 0.016) and DFS (27.0 vs. 11.3 months, P = 0.017) than those located in the upper and middle parts. Patients with N0 status experienced significantly better OS (21.4 vs. 11.6 months, P = 0.012) and DFS (21.4 vs. 8.6 months, P = 0.012) than those with N+ status. Patients whose tumor lengths were shorter than 5 cm had a better OS (17.4 vs. 5.7 months, P = 0.035) than those longer than 5 cm. Patients who underwent chemotherapy experienced a significantly improved OS (21.0 vs. 14.1 months, P = 0.032) compared to surgery alone. Multivariable analysis showed that lower tumor location, shorter tumor length, pN0 status and chemotherapy independently predicted better OS; lower tumor location and pN0 status independently predicted better DFS. Conclusions: Radical surgery in combination with chemotherapy has better outcomes than surgery alone for resectable SCCE. Higher tumor location, longer tumor length, lymph node metastasis and not undergoing chemotherapy independently predict worse prognoses.

Download Full-text

Small Cell Carcinoma Esophagus: Experience of an Indian Tertiary Cancer Center

10.21203/rs.3.rs-621928/v1 ◽

2021 ◽

Author(s):

Goutam Santosh Panda ◽

Vanita Noronha ◽

Subhash Yadav ◽

Amit Joshi ◽

Vijay Patil ◽

...

Keyword(s):

Overall Survival ◽

Cell Carcinoma ◽

Small Cell Carcinoma ◽

Median Overall Survival ◽

Local Therapy ◽

Cranial Irradiation ◽

Small Cell ◽

Cancer Center ◽

Carcinoma Of The Esophagus ◽

Stage Disease

Abstract Background: Small cell carcinoma of the esophagus (SCCE) is a rare and aggressive tumor with no established standard treatment.Methods: This is a retrospective study of adult patients with histologically proven SCCE registered between February 2011 and March 2020 at Tata Memorial Hospital in Mumbai.Results: There were 56 patients with 29 (51.8%) having limited-stage disease (LD) and 27 (48.2%) having extensive-stage disease (ED). The median age was 58 (IQR 51-65) years, 57.1% were men, 40% were smokers. Amongst LD-SCCE patients, 23 underwent local therapy i.e. radiation (19, 65.5%), surgery (4, 13.8%) and 27received chemotherapy in neoadjuvant (23, 79.3%), concurrent (18, 62.1%) and adjuvant (4,13.8%) settings. Total 19 ED-SCCE patients (70.4%) received chemotherapy. Prophylactic cranial irradiation (PCI) was delivered to 11(37.9%) and 7(25.9%) patients with LD-SCCE and ED-SCCE, respectively. Signiﬁcant grade ≥3 chemo-toxicities in patients with LD-SCCE and ED-SCCE included febrile neutropenia in 33.3% and 23.5%, anemia in 9.5% and 17.6%, and dyselectrolytemia in 14.3% and 11.8%, respectively. The median overall survival (OS) in LD-SCCE and ED-SCCE were 22.9 (95% CI 1.8-44.1) months and 11.8 (95% CI 7.3-16.4) months, respectively. Age <60years (p=0.004) and tumor epicenter in lower third esophagus (p=0.002) were good prognostic factors for OS in LD-SCCE and ED-SCCE patients respectively. The incidence of brain metastasis was low, both at presentation (1/27, 3.7%) and at relapse (5/56, 8.9%).Conclusion: Although the median overall survival of LD-SCCE is better than ED-SCCE, it is still under 2 years. Brain metastases are uncommon and the role of PCI is uncertain.

Download Full-text