Clinical characteristics, prognostic factors, and survival trends in esophageal neuroendocrine carcinomas: A population‐based study

Abstract

Background: Esophageal neuroendocrine carcinoma (ENEC) is an extremely rare type of malignancy. Clinical data of ENEC are limited to case reports and case series. More information is needed on its clinical feature, management, and prognosis. Methods: This study collected information of ENEC patients diagnosed pathologically from 2010 to 2018. Data including demographic information, clinical features, and survival trends were obtained from the Surveillance, Epidemiology, and End Results (SEER) database. Statistical analyses were performed with STATA/SE 15.1, SPSS 25.0, and GraphPad Prism 8.Results: A total of 283 ENEC patients were included in this study. The small-cell and large-cell subtypes of ENEC possess similar clinical features. The lower third of the esophagus (58%) was the most common location of ENEC. At the time of diagnosis, most ENEC patients were AJCC 7th stage IV (48.1%). Metastasis occurred in more than half of the ENEC patients (53.4%), and the most common metastatic site was the liver (37.1%). Compared with poorly differentiated esophageal squamous cell carcinoma (ESCC), another aggressive malignancy of the esophagus sometimes confused with ENEC because of similar histological features, our study showed differences in tumor location and metastatic rate, but similar poor survival rates. Multivariate survival analysis showed that ENEC located at the middle third of esophagus (p = 0.013), "Brain metastasis" (p = 0.019), and "Liver metastasis" (p < 0.001) were independent predictors of worse outcomes. "Surgery" (p = 0.003), and "Chemotherapy" (p < 0.001) were associated with better survival. Conclusion: A significant proportion of patients with newly diagnosed ENEC presented with metastatic disease. Predictors of poor survival included tumor location, brain metastasis, and liver metastasis. ENEC and poorly differentiated How to cite this article: Chen C, Hu H, Zheng Z, et al. Clinical characteristics, prognostic factors, and survival trends in esophageal neuroendocrine carcinomas: A population-based study.

Analysis of the influencing factors in the long-term survival of esophageal cancer

“…There are also some additional studies have found that the difference in tumor location does not have a statistically significant impact on patient prognosis ( 24 , 25 ). The findings of this study are consistent with Chen’s research ( 26 ), suggesting that the median survival time of patients with mid-thoracic ESCC is significantly lower than that of the patients with ESCC in the upper and lower segments. This can be attributed to the fact that the middle segment of the esophagus is deeper, surrounded by vital organs and structures, and has comparably less blood supply than the other segments.…”

Prognostic value of pretreatment 18F-FDG PET/CT metabolic parameters in esophageal high-grade neuroendocrine carcinoma: A bicenter retrospective study

“…The fact that distant metastasis is a known predictor of outcome further highlights the prognostic potential of MTV and TLG. In addition, lymph node metastasis ( 27 , 28 ), Ki-67 index ( 13 ), surgery ( 26 ), chemotherapy ( 26 ) have also been suggested as significant predictors of survival in esophageal NEC in previous studies. However, the univariate analysis in our study did not reveal significant association between these clinical factors and survival.…”

“…In a recent study by Chen et al., which included 283 patients with esophageal NEC and over half (53.4%) of the patients presented with distant metastasis at the time of diagnosis, distant metastasis was found to be significantly related to worse survival outcome ( 26 ). This is partly consistent with our finding.…”

Development and validation of prognostic nomograms in patients with gallbladder mucinous adenocarcinoma: A population-based study

“…Nomograms are utilized as a visual numerical graphical tool to forecast the probability of occurrence of a particular event based on data with known factors. In recent years, nomograms have been widely used to predict the prognosis of various cancers, such as esophageal, pancreatic, breast and prostate cancers ( 21 – 24 ). For gallbladder cancer, several nomograms with different predictive functions have also been developed ( 18 , 25 , 26 ).…”