Small Cell Carcinoma of the Esophagus

Jeene, Paul M.; Geijsen, Elisabeth D.; Muijs, Christina T.; Rozema, Tom; Aleman, Berthe M.P.; Müller, Karin; Baas, Jara M; Nuyttens, J.; Wouterse, Sanne J.; Braam, P.M.; Oppedijk, Vera; Ceha, Heleen M.; Cnossen, Jeltsje S.; Spruit, Patty H.; Bongers, E.; Berbée, Maaike; Mook, Stella; Hulshof, Maarten C.C.M.

doi:10.1097/coc.0000000000000546

Cited by 26 publications

(19 citation statements)

References 21 publications

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“…Our result indicated that the high response rate achieved by RT contributes to the survival benefit through long-duration remission. The median OS was 12.9 months in this study which was similar to previous reports (8–16 months) [2, 4]. The reported OS rates at 1-, 3- and 5-years in SCCE patients who received multiple therapeutics varied from 30 to 74.8%, 13.2–38.8%, and 7.8–18% respectively, and the survival data obtained in our study are almost equivalent to the best outcome [10–13).…”

Section: Discussionsupporting

confidence: 92%

“…The principles of chemotherapy for SCCE is poorly illustrated. According to a study focusing on the SCCE in locoregional disease treated with RT ± chemotherapy, more cycles of chemotherapy improved the survival, while the regiment and sequence of RT and chemotherapy had no impact on the disease control [4]. Unfortunately, due to a relatively small size of patients received chemotherapy in our study, we could not yield a reliable analysis to answer these questions.…”

Section: Discussionmentioning

confidence: 86%

“…When combined with chemotherapy, RT is considered a major local therapy approach for treating patients with localized or locoregional disease. Though RT is common in clinical practice in western countries, esophagectomy is more widely used compared to RT as the treatment for localized SCCE in China [2, 4]. A previous retrospective study of all the SCCE cases in our center from September 1990 to June 2011 showed that of 64 SCCE patients, only 15 (26.7%) patients received RT [5].…”

Section: Introductionmentioning

confidence: 99%

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

Chen

Yang

et al. 2019

Radiat Oncol

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BackgroundSmall 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.MethodsWe 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.ResultsOf 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.ConclusionRT 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.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 86%

Section: Introductionmentioning

confidence: 99%

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

Chen

Yang

et al. 2019

Radiat Oncol

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“…Patients with PSCCE are usually treated by surgical resection, chemotherapy (CT), and radiotherapy (RT) either alone or in combination (Meng et al, 2013 ; Wang et al, 2015 ; Zou et al, 2016 ; Xu et al, 2017 ). Despite progress in diagnostic technologies and treatment strategies, many patients with PSCCE are diagnosed at an advanced stage, and the median overall survival (OS) is only 12.5–16.7 months with traditional therapies (Xu et al, 1989 ; Lv et al, 2008 ; Zhu et al, 2014 ; Jeene et al, 2019 ). Therefore, it is necessary to identify new therapeutic targets for PSCCE.…”

Section: Introductionmentioning

confidence: 99%

CD155 Overexpression Correlates With Poor Prognosis in Primary Small Cell Carcinoma of the Esophagus

Zhao

Feng

et al. 2021

Front. Mol. Biosci.

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CD155/TIGIT overexpression has been detected in various human malignancies; however, its expression status in primary small cell carcinoma of the esophagus (PSCCE) and its prognostic significance remain unclear. In this study, we aimed to explore the expression and prognostic value of CD155 and TIGIT in PSCCE. We detected CD155 and TIGIT expression in 114 cases of PSCCE using immunohistochemistry (IHC) and evaluated their relationship with the clinicopathological characteristics and survival of the patients. Survival analyses were performed using the Kaplan-Meier method and Cox proportional hazards model. Nomogram performance was assessed via the concordance index (C-index) and calibration plots. Decision curve analysis (DCA) was performed to evaluate the net benefit of the nomogram. We found that CD155 and TIGIT were overexpressed in PSCCE tissues, CD155 expression correlated positively with TIGIT (p < 0.001) and was significantly associated with tumor size, T stage, distant metastasis, TNM stage, and Ki-67 score. TIGIT expression was also significantly associated with T stage, distant metastasis, and TNM stage. Patients with high CD155 and TIGIT expression had a significantly shorter overall survival (OS) and progression-free survival (PFS), while the multivariate model showed that CD155 expression and the therapeutic strategy are independent prognostic factors for PSCCE. In the validation step, OS was shown to be well-calibrated (C-index = 0.724), and a satisfactory clinical utility was proven by DCA. In conclusion, our findings revealed that CD155 and TIGIT are highly expressed in patients with PSCCE and are associated with shorter OS and PFS, supporting their role as prognostic biomarker.

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“… 16 However, univariate analysis did not detect any difference in survival in a separate study (31 vs 22, p =0.37). 28 This may be due to the fact that nearly half of all patients (48%) were diagnosed before 2008 and therefore were treated with relatively outdated technology. As well, a further 18% of patients demonstrated mixed histology.…”

Section: Discussionmentioning

confidence: 99%

Use of Chemoradiotherapy as a Treatment Option for Patients with Limited-Stage Primary Small Cell Carcinoma of the Esophagus

Zhao

Huang

et al. 2021

CMAR

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Purpose: Currently, there are no standard treatments for primary small cell carcinoma of the esophagus (PSCCE), particularly in cases of limited-stage disease. This retrospective study aimed to assess the treatment strategies and the relevant prognostic factors of limited-stage PSCCE (LS-PSCCE). Patients and Methods: We retrospectively evaluated 129 patients with LS-PSCCE between June 2009 and December 2018. The χ2 test was performed to examine the frequencies between different groups. The Kaplan-Meier and log-rank methods were used to estimate and compare survival rates. Univariate and multivariate analyses were performed to determine the prognostic factors for overall survival (OS). Results: Through a median follow-up of 23 months, the median OS of all patients was 25.0 months and the median recurrence-free survival (RFS) was 15.0 months. Univariate and multivariate analyses showed that alcohol abuse (p=0.046) and TNM stage (p<0.001) were independent prognostic factors. There was no significant difference in OS and RFS rates between the patients treated with chemoradiotherapy (CRT) and those treated with surgery and chemotherapy with or without radiotherapy (S+CT±RT) (p>0.05). Patients who received concurrent CRT had better OS and RFS than those who received sequential CRT (p<0.05). Postoperative adjuvant RT for high-risk patients can further improve the local control rate but has no significant effect on OS. Conclusion: LS-PSCCE patients treated with CRT had similar OS and RFS compared to those treated with S+CT±RT. This study shows that concurrent CRT confers a survival advantage for patients with LS-PSCCE compared to those with sequential CRT.

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Small Cell Carcinoma of the Esophagus

Abstract: Supplemental Digital Content is available in the text.

Cited by 26 publications

References 21 publications

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

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

CD155 Overexpression Correlates With Poor Prognosis in Primary Small Cell Carcinoma of the Esophagus

Use of Chemoradiotherapy as a Treatment Option for Patients with Limited-Stage Primary Small Cell Carcinoma of the Esophagus

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