Zhu Jiahao, Xu Benjie, Li Yuanyuan, Pang Xiangyi, Ji Shengjun, Lian Jie, Lu Haibo
Department of Outpatient Chemotherapy, Harbin Medical University Cancer Hospital, Harbin, China.
Department of Radiotherapy and Oncology, The Affiliated Suzhou Hospital of Nanjing Medical University, Gusu School, Nanjing Medical University, Suzhou, China.
Biomol Biomed. 2025 Apr 3;25(5):1009-1022. doi: 10.17305/bb.2024.11090.
Small cell esophageal carcinoma (SCEC) is a poorly differentiated esophageal neuroendocrine neoplasm with a poor prognosis. This study aimed to explore the factors and treatment approaches influencing the prognosis of SCEC. In this retrospective study, we collected data from the 18 Surveillance, Epidemiology, and End Results (SEER) registries cohort between 2004 and 2019, as well as from a Chinese institutional registry covering the period from 2012 to 2022. We assessed the annual percentage change (APC) in incidence of SCEC. Kaplan-Meier and Cox regression analyses were conducted to evaluate survival outcomes. Additionally, nomograms were developed for overall survival (OS) and cancer-specific survival (CSS) in the SEER cohort for SCEC and validated in an independent Chinese cohort. This analysis included 299 SCEC patients from the SEER cohort and 66 cases from the Chinese cohort. During the period of 2004-2019, the incidence of SCEC reached a plateau, with an APC of -1.40 (95% confidence interval [CI]: -4.3 to 1.40, P > 0.05). Multivariable Cox regression analysis revealed that age, distant metastasis, and chemotherapy were independent factors for OS, while distant metastasis and chemotherapy were independent factors for CSS. The nomograms developed for OS and CSS in SCEC exhibited remarkable accuracy and reliable predictive capacity in estimating 1-year, 3-year, and 5-year OS and CSS. SCEC is a rare malignancy with aggressive behavior. Distant metastasis is significantly associated with worse OS and CSS in patients with SCEC. Currently, chemotherapy remains the primary treatment approach for SCEC.
小细胞食管癌（SCEC）是一种分化差的食管神经内分泌肿瘤，预后较差。本研究旨在探讨影响SCEC预后的因素及治疗方法。在这项回顾性研究中，我们收集了2004年至2019年期间18个监测、流行病学和最终结果（SEER）登记处队列的数据，以及来自一个涵盖2012年至2022年期间的中国机构登记处的数据。我们评估了SCEC发病率的年度百分比变化（APC）。进行了Kaplan-Meier和Cox回归分析以评估生存结果。此外，还为SEER队列中的SCEC患者制定了总生存（OS）和癌症特异性生存（CSS）的列线图，并在一个独立的中国队列中进行了验证。该分析包括来自SEER队列的299例SCEC患者和来自中国队列的66例患者。在2004 - 2019年期间，SCEC的发病率达到平台期，APC为-1.40（95%置信区间[CI]：-4.3至1.40，P>0.05）。多变量Cox回归分析显示，年龄、远处转移和化疗是OS的独立因素，而远处转移和化疗是CSS的独立因素。为SCEC的OS和CSS制定的列线图在估计1年、3年和5年的OS和CSS方面表现出显著的准确性和可靠的预测能力。SCEC是一种具有侵袭性的罕见恶性肿瘤。远处转移与SCEC患者较差的OS和CSS显著相关。目前，化疗仍然是SCEC的主要治疗方法。
