National Cancer Database report of nonmetastatic esophageal small cell carcinoma

Vivek Verma, Richard L. Sleightholm, Penny Fang, Jeffrey M. Ryckman, Chi Lin

Research output: Contribution to journalArticle

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Abstract

Background: Esophageal small cell carcinoma (ESCC) is a rare malignancy for which there is no consensus management approach. This is the largest known analysis of nonmetastatic ESCC patients to date, evaluating national practice patterns and outcomes of surgical-based therapy vs chemoradiotherapy (CRT) vs chemotherapy alone. Methods: The National Cancer Data Base was queried for esophageal cancer patients with histologically confirmed nonmetastatic ESCC. Univariable and multivariable logistic regression ascertained factors associated with receipt of surgical-based management. Kaplan-Meier analysis evaluated overall survival (OS) and the log-rank test is used to compare OS between groups; Cox univariate and multivariate analyses determined variables associated with OS. Results: Altogether, 323 patients were analyzed; 64 (20%) patients underwent surgical-based therapy, 211 (65%) CRT, and 48 (15%) chemotherapy alone. On multivariable analysis, no single factor significantly predicted for administration of surgery. Despite no OS differences between the surgery-based (median OS 21 months) and CRT arms (18 months), both were superior to CT alone (10 months) (P < 0.001). Among other factors, receiving any local therapy independently predicted for higher OS over chemotherapy alone on Cox multivariate analysis (P < 0.001). Conclusions: This study of a large, contemporary national database demonstrates that most ESCC is treated with CRT in the United States; adding local therapy to systemic therapy may be beneficial to these patients, although individualized multidisciplinary management is still recommended.

Original languageEnglish (US)
Pages (from-to)6365-6373
Number of pages9
JournalCancer Medicine
Volume7
Issue number12
DOIs
StatePublished - Dec 1 2018

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Small Cell Carcinoma
Chemoradiotherapy
Databases
Survival
Neoplasms
Drug Therapy
Multivariate Analysis
Therapeutics
Kaplan-Meier Estimate
Esophageal Neoplasms
Logistic Models

Keywords

  • chemotherapy
  • esophageal cancer
  • radiation therapy
  • small cell carcinoma
  • surgery

ASJC Scopus subject areas

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

National Cancer Database report of nonmetastatic esophageal small cell carcinoma. / Verma, Vivek; Sleightholm, Richard L.; Fang, Penny; Ryckman, Jeffrey M.; Lin, Chi.

In: Cancer Medicine, Vol. 7, No. 12, 01.12.2018, p. 6365-6373.

Research output: Contribution to journalArticle

Verma, Vivek ; Sleightholm, Richard L. ; Fang, Penny ; Ryckman, Jeffrey M. ; Lin, Chi. / National Cancer Database report of nonmetastatic esophageal small cell carcinoma. In: Cancer Medicine. 2018 ; Vol. 7, No. 12. pp. 6365-6373.
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