Department of Radiation Oncology, University of Louisville Hospital, Louisville, KY, USA.
Department of Bioinformatics and Biostatistics, University of Louisville, Louisville, KY, USA.
Eur J Surg Oncol. 2020 Sep;46(9):1596-1604. doi: 10.1016/j.ejso.2020.04.017. Epub 2020 Apr 19.
Extrapulmonary small cell carcinoma is a rare malignancy with scarce data. Treatment paradigms extrapolate from pulmonary small cell carcinoma and single institution studies. We analyzed the epidemiology, patterns of care, prognostic factors, and overall survival (OS) of EPSCC patients.
The cohort included EPSCC. Patients with <2 months follow-up, unknown demographic/treatment variables were excluded. Descriptive statistics were performed to characterize the cohort. Kaplan-Meier methods were used to estimate OS. Cox proportional hazard modeling was done to analyze the influence of prognostic variables on OS.
5747 patients were included. Median OS was 1.2 years. Head and neck (HR: 0.60, 95% CI 0.53-0.67, p < 0.0001) and breast (HR: 0.69, 95% CI 0.53-0.89, p = .0046) were associated with improved OS; gastrointestinal (HR: 1.19, 95% CI 1.09-1.29, p < .0001) worse OS; and gynecologic (HR: 1.04, 95% CI 0.92-1.17, p = .5660) showing no difference, all compared to genitourinary (reference). Surgery was associated with improved overall survival (HR: 0.84, 95% CI 0.79-0.91, p=<.0001). Chemoradiation showed a decreased HR (HR: 0.91, 95% CI 0.83-0.99, p = .0363) when compared to chemotherapy alone (reference).
EPSCC occurs throughout the body with poor survival. Anatomic subsite was predictive for survival. Surgical resection may improve survival. Concurrent chemoradiation appears to improve survival over chemotherapy alone.
肺外小细胞癌是一种罕见的恶性肿瘤，相关数据很少。治疗模式是从肺小细胞癌外推而来的，并且是基于单机构研究的。我们分析了 EPSCC 患者的流行病学、治疗模式、预后因素和总生存率（OS）。
本队列纳入了 EPSCC 患者。排除了随访时间<2 个月、未知人口统计学/治疗变量的患者。采用描述性统计方法来描述队列。采用 Kaplan-Meier 方法估计 OS。采用 Cox 比例风险模型分析预后因素对 OS 的影响。
共纳入 5747 例患者。中位 OS 为 1.2 年。头颈部（HR：0.60，95%CI 0.53-0.67，p<0.0001）和乳腺（HR：0.69，95%CI 0.53-0.89，p=0.0046）与改善 OS 相关；胃肠道（HR：1.19，95%CI 1.09-1.29，p<0.0001）与 OS 恶化相关；妇科（HR：1.04，95%CI 0.92-1.17，p=0.5660）与 OS 无差异，均与泌尿生殖系统（参考）相比。手术与改善总体生存率相关（HR：0.84，95%CI 0.79-0.91，p<0.0001）。与单独化疗相比，放化疗（HR：0.91，95%CI 0.83-0.99，p=0.0363）显示出较低的 HR。
EPSCC 发生在全身各处，生存率差。解剖部位与生存相关。手术切除可能改善生存。与单独化疗相比，同期放化疗似乎能提高生存率。
