Preoperative Chemotherapy for Limited-stage Small Cell Carcinoma of the Esophagus

Cai, Gaoke; Zou, Bingwen; Zhao, Wensi; Cheng, Xinyu; Shi, Ke; Qiu, Hu; Jiamei, Chen; Shi, Wei; Gao, Lijuan; Wang, Chenyu; Wang, Jun; Chen, Yongshun

doi:10.1016/j.athoracsur.2021.08.059

Cited by 7 publications

(3 citation statements)

References 20 publications

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“…This situation leads to a significant reduction in the clinical therapeutic efficacy as well as the quality of life of patients. This study showed that PSCCE mostly occurred in the middle and lower thoracic esophagus (91.60%), which was consistent with previous studies [ 8 , 15 , 16 ].…”

Section: Discussionsupporting

confidence: 93%

The Survival and Prognosis Characteristics of Primary Esophageal Small-Cell Carcinoma

Zhang

et al. 2022

Disease Markers

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Objective. To comprehensively explore the survival characteristics of primary esophageal small-cell carcinoma (PSCCE) and identify the main factors affecting the prognosis. Methods. The clinical and follow-up data of PSCCE patients admitted to the Fourth Hospital of Hebei Medical University from 2006 to 2010 were retrospectively analyzed. The primary endpoint was five-year survival. Survival curves were drawn using the Kaplan-Meier method, and log-rank test was used to compare the differences in survival rates among the groups. Cox regression models were used to analyze prognostic factors. Results. A total of 119 eligible patients were retrieved. Median survival was 27 months (3-100 months). Changes in overall survival (OS) in PSCCE patients were associated with TNM stage ( P = 0.007 ), T stage ( P = 0.049 ), and lymph node metastasis ( P = 0.004 ). When TNM was in stage I-IIb, lymph node metastasis ( P = 0.003 ) or combined adjuvant therapy ( P = 0.004 ) was an independent factor affecting OS. Survival analysis showed that TNM staging had no predictive value for 5-year survival time or disease-free survival (DFS) of PSCCE ( P > 0.05 ). Conclusion. TNM stage, T stage, and lymph node metastasis were related to the survival of patients. Negative lymph node metastasis and treatment are independent prognostic factors in PSCCE TNM stage I-IIb patients.

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Section: Discussionsupporting

confidence: 93%

The Survival and Prognosis Characteristics of Primary Esophageal Small-Cell Carcinoma

Zhang

et al. 2022

Disease Markers

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“…Zou et al found that adjuvant chemotherapy or chemo-RT could improve the disease-free survival (DFS) and OS compared with surgery alone ( 25 ). Another analysis indicated that preoperative chemotherapy could significantly improve the OS and reduce the risk of distant migration in locally advanced ENEC ( 26 ). The median OS in the preoperative group reached 26 months.…”

Section: Discussionmentioning

confidence: 99%

Comparison of clinicopathological features and survival analysis between esophageal neuroendocrine carcinoma and esophageal squamous cell carcinoma based on the SEER database, alongside nomogram analysis for esophageal neuroendocrine carcinoma

Lin,

Chen,

Liu

et al. 2023

J Gastrointest Oncol

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Background Esophageal neuroendocrine carcinoma (ENEC) is a rare subtype of esophageal cancer (EC). It presents distinctive clinical and pathological features in comparison to esophageal squamous cell carcinoma (ESCC). To better elucidate the disparities between the two and establish a prognostic prediction model for ENEC, we conducted this study. Methods Data of ENEC and ESCC patients (1975 to 2016) were extracted from the Surveillance, Epidemiology and End Results (SEER) database. Patients with a confirmed pathological diagnosis of ENEC and ESCC were enrolled in the study. The Chi-square test was employed to compare categorical variables, and the median survival time was analyzed using the Kaplan-Meier curve. Training and validation groups were randomly assigned at a ratio of 7:3. Factors with a significance level of <0.05 in the multifactor regression model as well as age were integrated into the nomogram model. Concordance index (C-index), calibration curves, and decision curve analyses (DCA) were generated for model validation. Results This study encompassed a total of 737 ENEC patients and 29,420 ESCC. Compared to ESCC, ENEC patients had higher probability of liver metastasis (13.8% vs. 1.9%, P<0.001), poor differentiation (68.0% vs. 37.1%, P<0.001), and late SEER stage (52.8% vs. 26.9%, P<0.001). Patients who received either surgery, radiotherapy (RT), or chemotherapy had a significantly longer disease-specific survival (DSS) and overall survival (OS) (all P<0.001). After propensity score matching (PSM), ENEC patients were associated with shorter DSS (7.0 months vs. not reached, P<0.0001) and OS (7.0 vs. 12.0 months, P<0.0001) compared to ESCC. Race, SEER stage, surgery, RT, and chemotherapy were identified as predictors of DSS and were incorporated into the nomogram model together with age. The validation of the model using C-index (0.751 and 0.706, respectively) and calibration curves reflected the better discrimination power of the model. In addition, DCA supported the favorable potential clinical effect of the predictive model. Lastly, a risk classification based on the nomogram also verified the reliability of the model. Conclusions ENEC and ESCC exhibit distinct clinicopathological features. Patients with ENEC experience significantly poorer survival outcomes compared to those with ESCC. Surgical intervention, radiation therapy, and chemotherapy significantly improve OS and DSS for ENEC patients. The nomogram prediction model, constructed based on age, race, stage, and treatment regimen, demonstrates accurate and effective predictive capabilities for prognostic factors in ENEC patients.

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“…However, most patients with nodal disease received adjuvant therapy. Cai et al 24 reported that preoperative chemotherapy plus surgery improved SCCE patient survival compared with surgery alone. However, their study included many cases of R1/R2 resection, which possibly weakens the conclusion.…”

Section: Discussionmentioning

confidence: 99%

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

Yang

Shi

et al. 2022

Journal of Surgical Oncology

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Background This study aimed to investigate the efficacy of surgery in the treatment of small cell carcinoma of the esophagus (SCCE) and explore potential prognostic factors. Methods We screened patients with SCCE who underwent esophagectomy from 2010 to 2018 at three institutes. Differences in survival were analyzed using the Kaplan–Meier method and log–rank test. The prognostic factors were identified using univariate and multivariate analyses. Results A total of 69 patients were included. Multivariate analysis showed that TNM stage (hazard ratio [HR]: 4.10, 95% confidence interval [CI]: 1.57–10.75, p = 0.004) and adjuvant therapy (HR: 0.28, 95% CI: 0.16–0.51, p < 0.001) were independent prognostic factors. Stage I, stage IIA, and stage IIB disease were merged into the surgery response disease (SRD), whereas stage III disease into the surgery nonresponse disease (SNRD). The SRD group had significantly improved survival compared to the SNRD group (HR: 0.33, 95% CI: 0.19–0.58, p < 0.001). In addition, adjuvant therapy increased survival benefit in the SNRD group (p < 0.001) but not in the SRD group (p = 0.061). Conclusions Surgery alone appears to be adequate for disease control in the SRD group, whereas multimodality therapy was associated with improved survival in the SNRD group.

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Preoperative Chemotherapy for Limited-stage Small Cell Carcinoma of the Esophagus

Cited by 7 publications

References 20 publications

The Survival and Prognosis Characteristics of Primary Esophageal Small-Cell Carcinoma

The Survival and Prognosis Characteristics of Primary Esophageal Small-Cell Carcinoma

Comparison of clinicopathological features and survival analysis between esophageal neuroendocrine carcinoma and esophageal squamous cell carcinoma based on the SEER database, alongside nomogram analysis for esophageal neuroendocrine carcinoma

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

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