Curative effect analysis of different clinical characteristics and treatment modalities for primary esophageal small cell carcinoma

doi:10.3760/cma.j.issn.1673-422X.2019.03.001

Abstract

Abstract: ObjectiveTo analyze the efficacy of different clinical characteristics and treatment modalities for patients with primary esophageal small cell carcinoma (PESC), and to find out the prognostic factors, and provide reference for clinical treatment decision. MethodsPatients with PESC who were treated at Shandong Cancer Hospital Affiliated to Shandong University from January 2008 to May 2017 were retrospectively enrolled. The clinical features were collected. Their disease progression time and survival status were determined by followup, and the followup ended in October 2017. Data analysis was performed using SPSS 25.0 software, and GraphPad Prism 7.0 was used for mapping. Survival analysis was performed by KaplanMeier method, and logrank test was used to compare the differences in survival curves of each group. Factors with significant differences in univariate analysis were included in the Cox multivariate survival analysis. ROC curve was used to verify the sensitivity and specificity of the model. ResultsA total of 83 PESC patients with a complete followup were included in the study, including 68 males and 15 females. The average age was 61.93 years old (4182 years old). The median progressionfree survival (PFS) was 9.1 months (1.060.0 months) and the median overall survival (OS) was 26.1 months (1.860.0 months). Cox multivariate survival analysis showed radiotherapy or not (HR=0.321, 95%CI: 0.1840.559, P＜0.001) and chemotherapy cycles (HR=0.841, 95%CI: 0.7370.960，P=0.010) were independent prognostic factors for PFS. The Veterans Administration Lung Study Group (VALSG) staging (HR=3.050, 95%CI: 1.6065.794, P=0.001), radiotherapy or not (HR=0.312, 95%CI: 0.1740.560, P＜0.001), and chemotherapy cycle (HR=0.711, 95%CI: 0.6010.842, P＜0.001) were independent predictors of OS. The ROC curve showed that the sensitivity and specificity of the PFS prediction model were 78.26% and 73.33%, and the sensitivity and the specificity of the OS prediction model were 80.00% and 58.49%. ConclusionVALSG staging is an independent predictor of PESC survival. Comprehensive therapy based on radiotherapy and chemotherapy can improve disease control, reduce metastasis, and improve survival.

Key words: Treatment effectiveness, Prognosis;, Comprehensive treatment, Primary esophageal small cell carcinoma

Li Zhe，Xing Yanke，Li Baosheng. Curative effect analysis of different clinical characteristics and treatment modalities for primary esophageal small cell carcinoma[J]. Journal of International Oncology, 2019, 46(3): 129-134.

References

［1］ Kukar M, Groman A, Malhotra U, et al. Small cell carcinoma of the esophagus: a SEER database analysis［J］. Ann Surg Oncol, 2013, 20(13): 42394244. DOI: 10.1245/s1043401331673. ［2］ Isolauri J, Mattila J, Kallioniemi OP. Primary undifferentiated small cell carcinoma of the esophagus: clinicopathological and flow cytometric evaluation of eight cases［J］. J Surg Oncol, 1991, 46(3): 174177. DOI: 10.1002/jso.2930460310. ［3］吕纪马, 梁军, 王金万, 等. 126例小细胞食管癌的临床分析［J］. 中华肿瘤杂志, 2009, 31(2): 121125. DOI: 10.3760/cma.j.issn.02533766.2009.02.010. ［4］郭杨, 王瑞, 姚计方, 等. 原发性食管小细胞癌89例临床分析［J］. 中国综合临床, 2005, 21(10): 905907. DOI: 10.3760/cma.j.issn.10086315.2005.10.020. ［5］宋岩, 王绿化, 赫捷, 等. 151例食管小细胞癌的治疗与预后分析［J］. 癌症, 2009, 28(3): 303307. DOI: 10.3321/j.issn:1000467X.2009.03.014. ［6］焦文鹏, 曹峰, 王军. 食管小细胞癌研究现状［J］. 中华肿瘤防治杂志, 2015, 22(4): 315319. DOI: 10.16073/j.cnki.cjcpt.2015.04.016. ［7］ Richardson RL, Weiland LH. Undifferentiated small cell carcinomas in extrapulmonary sites［J］. Semin Oncol, 1982, 9(4): 484496. DOI: 10.1002/mpo.2950100608. ［8］ Walenkamp AM, Sonke GS, Sleijfer DT. Clinical and therapeutic aspects of extrapulmonary small cell carcinoma［J］. Cancer Treat Rev, 2009, 35(3): 228236. DOI: 10.1016/j.ctrv.2008.10.007. ［9］ Frazier SR, Kaplan PA, Loy TS. The pathology of extrapulmonary small cell carcinoma［J］. Semin Oncol, 2007, 34(1): 3038. DOI: 10.1053/j.seminoncol.2006.11.017. ［10］ Zhu Y, Qiu B, Liu H, et al. Primary small cell carcinoma of the esophagus: review of 64 cases from a single institution［J］. Dis Esophagus, 2014, 27(2): 152158. DOI: 10.1111/dote.12069. ［11］ Al Mansoor S, Ziske C, SchmidtWolf IG. Primary small cell carcinoma of the esophagus: patient data metaanalysis and review of the literature［J］. Ger Med Sci, 2013, 11: Doc12. DOI: 10.3205/000180. ［12］ Ho KJ, Herrera GA, Jones JM, et al. Small cell carcinoma of the esophagus: evidence for a unified histogenesis［J］. Hum Pathol, 1984, 15(5): 460468. DOI: 10.1016/s00468177(84)800817. ［13］ Markogiannakis H, Theodorou D, Toutouzas KG, et al. Small cell carcinoma arising in Barrett′s esophagus: a case report and review of the literature［J］. J Med Case Rep, 2008, 2: 15. DOI: 10.1186/17521947215. ［14］ Ishida H, Kasajima A, Kamei T, et al. SOX2 and Rb1 in esophageal smallcell carcinoma: their possible involvement in pathogenesis［J］. Mod Pathol, 2017, 30(5): 660671. DOI: 10.1038/modpathol.2016.222. ［15］ Kenji N, HengJiang Z, Takumi G, et al. Radiation therapy for limitedstage smallcell esophageal cancer［J］. Am J Clin Oncol, 2002, 25(4): 404407. DOI: 10.1097/0000042120020800000017. ［16］ Hosokawa A, Shimada Y, Matsumura Y, et al. Small cell carcinoma of the esophagus. Analysis of 14 cases and literature review［J］. Hepatogastroenterology, 2005, 52(66): 17381741. DOI: 10.1136/gut.2005.064824. ［17］王准, 封巍, 郑晓, 等. 食管小细胞癌的临床分析［J］. 中国癌症杂志, 2006, 16(6): 508510. DOI: 10.3969/j.issn.10073639.2006.06.022. ［18］李辉, 刘曙光, 刘希斌, 等. 原发性食管小细胞癌47例预后分析［J］. 肿瘤， 2009， 29(2): 180183. DOI: 10.3781/j.issn.10007431.2009.02.018. ［19］ Verma V, Sleightholm RL, Fang P, et al. National Cancer Database report of nonmetastatic esophageal small cell carcinoma［J］. Cancer Med, 2018, 7(12): 63656373. DOI: 10.1002/cam4.1712. ［20］ Meng MB, Zaorsky NG, Chao J, et al. Radiotherapy and chemotherapy are associated with improved outcomes over surgery and chemotherapy in the management of limitedstage small cell esophageal carcinoma［J］. Radiother Oncol, 2013, 106(3): 317322. DOI: 10.1016/j.radonc.2013.01.008. ［21］ Kazushige A, Yoshiyuki S, Satoshi N, et al. Chemoradiation for small cell esophageal carcinoma: report of 11 cases from multiinstitution experience［J］. J Radiat Res, 2010, 51(1): 1520. DOI: 10.1269/jrr.09074. ［22］ Yan H, Wang R, Jiang S, et al. NSE can predict the sensitivity to definitive chemoradiotherapy of small cell carcinoma of esophagus［J］. Med Oncol, 2014, 31(1): 796. DOI: 10.1007/s1203201307960. ［23］ Zhang Y, Li C, Chen M. Prognostic value of immunohistochemical factors in esophageal small cell carcinoma (ESCC): analysis of clinicopathologic features of 73 patients［J］. J Thorac Dis, 2018, 10(7): 40234031. DOI: 10.21037/jtd.2018.06.26.

[1]	Du Chen, Su Siyu, Wang Lige, Yu Guiping. Advances in neoadjuvant therapy of esophageal cancer involved in organ preservation [J]. Journal of International Oncology, 2021, 48(11): 673-677.
[2]	Peng Yancai, Hao Dengrong. Expression and clinical significance of ribosome-binding protein 1 in esophageal carcinoma [J]. Journal of International Oncology, 2019, 46(11): 668-672.
[3]	Xu Xiang, He Qingwen, Xiao Caiwen. Prognostic evaluation of Ki67 and derived neutrophil-lymphocyte ratio in patients with nasopharyngeal carcinoma [J]. Journal of International Oncology, 2018, 45(12): 711-715.
[4]	CAI Xian-Lei-；Wu-Jian-；Zheng-Shu-Sen. Effect of tumor-stroma ratio in prognosis evaluation of tumor [J]. Journal of International Oncology, 2015, 42(4): 284-287.