Haider Kamal, Shahid Rabia K, Finch Daygen, Sami Amer, Ahmad Imran, Yadav Sunil, Alvi Riaz, Popkin David, Ahmed Shahid
Department of Medical Oncology, Saskatoon Cancer Center, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Cancer. 2006 Nov 1;107(9):2262-9. doi: 10.1002/cncr.22235.
The objective of this study was to determine variables that correlate with the survival of patients with extrapulmonary small cell carcinoma (EPSCC).
Medical records of 101 eligible patients with EPSCC who were diagnosed in Saskatchewan from 1971 to 2002 were reviewed. Survival was calculated by using the Kaplan-Meier method. A logistic regression analysis with a backward elimination was carried out to determine prognostic variables that predicted mortality.
The median patient age was 72 years (range, 24-100 years), and the male-to-female ratio was 1.4:1. The primary disease sites were as follows: breast, 9%; gastrointestinal, 20%; genitourinary, 18%; gynecologic, 11%; head and neck, 10%; thymus, 2%; and unknown primary site, 31%. Fifty-one patients had limited disease (LD), and 50 patients had extensive disease (ED). Patients with LD had a median overall survival of 34 months (range, 0.2-276 months) compared with 2 months (range, 0.1-108 months) in patients with ED (P < .0001). Among different primary sites, patients with gynecologic small cell cancer (SCC) had a median survival of 54.4 months, whereas patients with SCC of an unknown primary site had a survival of 2.5 months. Among various variables that were examined with respect to their prognostic importance, an abnormal white blood cell count (odds ratio [OR], 6.9; 95% confidence interval [95% CI], 3.4-14.1), an Eastern Cooperative Oncology Group performance status >2 (OR, 4.5; 95% CI, 2.1-9.9), and ED (OR, 2.7; 95% CI, 1.4-5.0) were found to be correlated significantly with mortality.
The gastrointestinal and genitourinary tracts were the 2 major sites involved by EPSCC in the current series. Survival varied according to the primary sites, and patients with gynecologic tumors had the best prognosis. An abnormal white blood cell count, a poor performance status, and disease extent were important factors in predicting survival.
本研究的目的是确定与肺外小细胞癌（EPSCC）患者生存相关的变量。
回顾了1971年至2002年在萨斯喀彻温省确诊的101例符合条件的EPSCC患者的病历。采用Kaplan-Meier法计算生存率。进行了向后逐步回归的逻辑回归分析，以确定预测死亡率的预后变量。
患者的中位年龄为72岁（范围24 - 100岁），男女比例为1.4:1。原发疾病部位如下：乳腺，9%；胃肠道，20%；泌尿生殖系统，18%；妇科，11%；头颈部，10%；胸腺，2%；原发部位不明，31%。51例患者为局限性疾病（LD），50例患者为广泛性疾病（ED）。LD患者的中位总生存期为34个月（范围0.2 - 276个月），而ED患者为2个月（范围0.1 - 108个月）（P <.0001）。在不同的原发部位中，妇科小细胞癌（SCC）患者的中位生存期为54.4个月，而原发部位不明的SCC患者生存期为2.5个月。在就其预后重要性进行检查的各种变量中，白细胞计数异常（比值比[OR]，6.9；95%置信区间[95%CI]，3.4 - 14.1）、东部肿瘤协作组体能状态>2（OR，4.5；95%CI，2.1 - 9.9）和ED（OR，2.7；95%CI，1.4 - 5.0）被发现与死亡率显著相关。
在本系列中，胃肠道和泌尿生殖系统是EPSCC累及的两个主要部位。生存期因原发部位而异，妇科肿瘤患者的预后最佳。白细胞计数异常、体能状态差和疾病范围是预测生存的重要因素。
