Treatment Strategies and Prognostic Factors of Limited-Stage Primary Small Cell Carcinoma of the Esophagus

Liu, Xu; Li, Yin; Liu, Xianben; Sun, Haibo; Zhang, Ruixiang; Zhang, Jianbo; Zheng, Yan; Wang, Zongfei; Liu, Shilei; Chen, Xiankai

doi:10.1016/j.jtho.2017.09.1966

Cited by 47 publications

(66 citation statements)

References 40 publications

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“…However, the United States is one of the low‐incidence regions of esophageal cancer, and the most common pathological type is adenocarcinoma, originating mostly in the lower third of the esophagus . In the present study, in the Chinese SCCE group, patient age, sex, primary tumor location, and tumor length were similar to that of esophageal squamous cell carcinoma, in accordance with the results of previous reports from China . In contrast, the clinical features of SCCE patients in the U.S. group were more similar to that of adenocarcinoma .…”

Section: Discussionsupporting

confidence: 90%

“…In our study, the OS of the Chinese group was higher than that of the U.S. group, but the survival difference disappeared after PSM, suggesting that there was no significant difference in the prognosis of SCCE between the two groups if the disparities in patient age, sex, and VALSG stage were removed. Furthermore, previous studies have reported similar pathological features, immunohistochemical staining, and aggressive nature of SCCE among different worldwide populations , , , . Therefore, we concluded that SCCE from different populations should be analyzed as a single entity, though there might be discrepancies in the pathogenesis, demographics, and certain clinical features.…”

Section: Discussionmentioning

confidence: 62%

“…A larger retrospective study based on the National Cancer Data Base proved that esophagectomy improved the survival of patients with localized disease (node‐negative) compared with chemotherapy alone or chemoradiotherapy . Furthermore, several other studies demonstrated that radical esophagectomy achieved the best survival in patients with stage I/IIA SCCE. In the present study, a stratified analysis based on VALSG stage grouping revealed that radical resection had a tendency to achieve longer survival in patients with localized disease, though this was not statistically significant.…”

Section: Discussionmentioning

confidence: 99%

“…Primary small cell carcinoma of the esophagus (SCCE) is a highly aggressive malignancy with early metastasis and a dismal prognosis . Because of the rarity of the disease, the optimal standard treatment for SCCE remains undetermined.…”

Section: Introductionmentioning

confidence: 99%

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Primary small cell carcinoma of the esophagus: Comparison between a Chinese cohort and Surveillance, Epidemiology, and End Results (SEER) data

Xiao

Ouyang

et al. 2019

Cancer Medicine

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Background The optimal standard treatment for primary small cell carcinoma of the esophagus (SCCE) remains undetermined. In this study, we conducted two areas of research on SCCE. First, we analyzed differences in SCCE characteristics between Chinese and U.S. patients. Second, we evaluated optimal treatment strategies for SCCE in the Chinese cohort. Methods Data from 137 Chinese SCCE patients collected from two cancer centers in China were compared with 385 SCCE patients registered in the U.S. SEER program. Prognostic factors were further analyzed in the Chinese group. Propensity score matching (PSM) was used to balance baseline features between the groups. Results There were more Chinese SCCE patients with regional stage disease (41.6%) and surgery was the principal local therapy (78.1%), while 51.7% of U.S. patients was at advanced stages and tended to receive radiotherapy as the main therapy (45.2%). Median overall survival (MST) of Chinese patients was 15.0 months, compared with 8.0 months for U.S. patients (P < 0.001). However, the survival differences between groups disappeared after PSM (MST: 12.5 m vs 9.0 m, P = 0.144). Further analysis found that surgery tended to achieve clinical benefits only for patients with localized disease (T1‐4aN0M0). Radiotherapy and chemotherapy may prolong survival in patients with regional and extensive disease. Conclusions Although there are huge differences in the tumor characteristics and treatment modalities of SCCE between Chinese and U.S. patients, the prognosis of SCCE is equally poor in both. Surgery should be considered for patients with localized disease, while chemoradiotherapy is recommended for patients with regional and extensive disease.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Primary small cell carcinoma of the esophagus: Comparison between a Chinese cohort and Surveillance, Epidemiology, and End Results (SEER) data

Xiao

Ouyang

et al. 2019

Cancer Medicine

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“…The common types of esophageal cancer are squamous cell carcinoma and adenocarcinoma and primary small cell carcinoma of the esophagus (PSCCE) which is a relatively rare histological subtype, accounting for only 0.5–2.8% of all esophageal malignant tumors . PSCCE is characterized by high aggression, early dissemination and poor prognosis . Although the first case was noticed by McKeown in 1952, the lower incidence of PSCCE made it is difficult to establish a standard treatment .…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of pretreatment inflammatory biomarkers in primary small cell carcinoma of the esophagus

Wang

Luo

et al. 2019

Thoracic Cancer

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Background Growing evidence indicates that several inflammatory biomarkers may predict survival in patients with malignant tumors. The aim of this study was to evaluate the prognostic value of pretreatment biomarkers in patients with primary small‐cell carcinoma of the esophagus (PSCCE). Methods A total of 73 PSCCE patients enrolled between January 2009 and December 2017 at the Affiliated Cancer Hospital of Zhengzhou University. The total lymphocyte counts (TLC), neutrophil‐to‐lymphocyte ratio (NLR) and platelet‐to‐lymphocyte ratio (PLR) prior to anticancer therapy were collected as inflammation biomarkers. The cutoff value was determined by Receiver operating characteristic (ROC). The Kaplan‐Meier method was utilized to analyze overall survival (OS). Cox proportional hazards regression was used to identify univariate and multivariate prognostic factors. Results Univariate analysis showed that high NLR group (hazard ratio [HR] = 1.685; 95% CI: 1.001–2.838; P = 0.047) and high PLR group (hazard ratio [HR] = 1.716; 95% CI: 1.039–2.834; P = 0.033) were associated with poor OS, and TLC was not correlated with OS. On multivariate analysis, high PLR (hazard ratio [HR] = 1.751; 95% CI: 1.042–2.945; P = 0.035) was an independent prognostic factor of unfavorable OS. Conclusions Pretreatment PLR and NLR are correlated with OS. These biomarkers are easily accessible, cost effective, and can serve as a marker to identify high‐risk patients for further designing personalized treatment and predicting treatment outcomes.

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Clinical outcomes of locally advanced esophageal neuroendocrine carcinoma treated with chemoradiotherapy

et al. 2019

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Background: Neuroendocrine carcinoma (NEC) arising from the esophagus (EsoNEC) is extreme rare, accounting for approximately 1% of esophageal cancer.Even for localized NEC, multidisciplinary approach including chemotherapy is recommended in treatment guidelines because of its high rates of systemic recurrence.However, it is controversial whether adding surgery or radiotherapy is appropriate local treatment for EsoNEC. There have been few reports regarding the clinical outcomes of definitive chemoradiotherapy (dCRT) for EsoNEC. The purpose of this study was to clarify the survival outcome of patients with locally advanced EsoNEC treated with dCRT. Methods: Clinical outcomes, feasibility, and prognostic factors of patients with locally advanced EsoNEC treated with radiotherapy (60 Gy/30 fraction) in combination with platinum plus etoposide (CE-RT) or cisplatin plus 5-fluorouracil (CF-RT) at the National Cancer Center Hospital from 2001 to 2017 were retrospectively analyzed. Results: A total of 22 patients were identified as the subjects of this study. The overall response rate and clinical complete remission rate in all patients were 86.4% and 77.3%, respectively. The median progression-free survival and median survival time in all patients were 12.7 and 37.5 months, associated with a 5-year survival rate of 45.4%. Patients treated with CE-RT experienced more hematological adverse events, especially in neutropenia (≥grade 3) and febrile neutropenia(≥grade 3), but achieved more long-term progression-free survival than with CF-RT. Conclusions: Definitive chemoradiotherapy can be considered as an important treatment option for locally advanced esophageal neuroendocrine carcinoma. K E Y W O R D S chemoradiotherapy, esophageal neuroendocrine carcinoma, etoposide, multidisciplinary treatment, platinum 596 | HONMA et Al.

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Treatment Strategies and Prognostic Factors of Limited-Stage Primary Small Cell Carcinoma of the Esophagus

Cited by 47 publications

References 40 publications

Primary small cell carcinoma of the esophagus: Comparison between a Chinese cohort and Surveillance, Epidemiology, and End Results (SEER) data

Primary small cell carcinoma of the esophagus: Comparison between a Chinese cohort and Surveillance, Epidemiology, and End Results (SEER) data

Prognostic value of pretreatment inflammatory biomarkers in primary small cell carcinoma of the esophagus

Clinical outcomes of locally advanced esophageal neuroendocrine carcinoma treated with chemoradiotherapy

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