National Cancer Database report of nonmetastatic esophageal small cell carcinoma

Abstract

BackgroundEsophageal small cell carcinoma (ESCC) is a rare malignancy for which there is no consensus management approach. This is the largest known analysis of nonmetastatic ESCC patients to date, evaluating national practice patterns and outcomes of surgical‐based therapy vs chemoradiotherapy (CRT) vs chemotherapy alone.MethodsThe National Cancer Data Base was queried for esophageal cancer patients with histologically confirmed nonmetastatic ESCC. Univariable and multivariable logistic regression ascertained factors associated with receipt of surgical‐based management. Kaplan‐Meier analysis evaluated overall survival (OS) and the log‐rank test is used to compare OS between groups; Cox univariate and multivariate analyses determined variables associated with OS.ResultsAltogether, 323 patients were analyzed; 64 (20%) patients underwent surgical‐based therapy, 211 (65%) CRT, and 48 (15%) chemotherapy alone. On multivariable analysis, no single factor significantly predicted for administration of surgery. Despite no OS differences between the surgery‐based (median OS 21 months) and CRT arms (18 months), both were superior to CT alone (10 months) (P < 0.001). Among other factors, receiving any local therapy independently predicted for higher OS over chemotherapy alone on Cox multivariate analysis (P < 0.001).ConclusionsThis study of a large, contemporary national database demonstrates that most ESCC is treated with CRT in the United States; adding local therapy to systemic therapy may be beneficial to these patients, although individualized multidisciplinary management is still recommended.

Neoadjuvant chemoimmunotherapy for small cell carcinoma of the esophagus: Clinical efficacy and biomarker exploration

“…With the application of systemic therapy, researchers have found that adding local surgical resection to systemic treatment significantly improves survival. 22 Although case 2 in this study achieved significant remission after treatment, pCR was not achieved. Surgical resection may have potential benefits in preventing recurrence.…”

Limited‐stage small cell carcinoma of the esophagus treated with curative esophagectomy: A multicenter retrospective cohort study

“…In contrast, several studies have showed that surgical resection was beneficial. 13 , 14 Verma et al 15 have indicated that adding surgery or radiotherapy to chemotherapy led to improved long‐term survival outcomes. In addition, Chen et al 16 have reported that surgical resection alone was adequate for patients with early‐stage SCCE.…”

Nomogram for the prediction of individualized overall survival of patients diagnosed with small cell esophageal carcinoma

“…Due to the rarity and tumour heterogeneity of SCEC, a specific staging system, clinical trials, or standard treatment have not as yet been established. Additionally, as SCEC is a highly aggressive malignancy with dismal survival, considerable controversy regarding its prognostic factors exists, with the few studies investigating this being retrospective, with small sample size, and producing inconsistent results (9)(10)(11)(12)(13).…”