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Small Cell Carcinoma of the Esophagus: A SEER Database Analysis

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Small cell cancer (SCC) of the esophagus is an uncommon malignancy with perceived poor prognosis, but there are few data to guide therapeutic decisions. We examined the Surveillance, Epidemiology, and End Results (SEER) database to identify prognostic factors for survival.

Methods

All patients with esophageal cancer in the SEER database between 1973 and 2009 were included. Univariate and multivariate analyses were performed in patients with and without SCC, examining the relationship of small cell histology, surgery, and other potential prognostic factors with overall survival (censored at 72 months).

Results

Of 64,799 esophageal cancer patients identified in the SEER database, 387 (0.6 %) had small cell histology. As compared with non-small cell histology, patients with small cell histology were similar in age and race but had a higher proportion of women (p < 0.001), had a higher stage at diagnosis (p < 0.001), and were less likely to undergo surgical resection (p < 0.01). Multivariate predictors associated with poor survival in the overall cohort included age, female gender, black race, and stage. In patients treated with surgery, multivariate predictors associated with poor survival included age, male gender, race, and stage but not small cell histology. In patients with small cell histology, both age and stage were associated with poor survival, but surgery and preoperative radiotherapy were associated with improved survival.

Conclusions

SCC of the esophagus presents at an advanced stage and confers a poor prognosis. The survival benefit of surgery and radiotherapy suggests that all esophageal SCC patients should be considered for preoperative radiotherapy and surgery in a stage-appropriate fashion.

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Disclosure

The authors declare no conflict of interest.

Author information

Authors and Affiliations

  1. Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY, USA

    Moshim Kukar MD

  2. Department of Biostatistics, Roswell Park Cancer Institute, Buffalo, NY, USA

    Adrienne Groman MS

  3. Department of Medicine, Roswell Park Cancer Institute, Buffalo, NY, USA

    Usha Malhotra MD

  4. Department of Radiation Oncology, Medical University of South Carolina, Charleston, SC, USA

    Graham W. Warren MD

  5. Department of Pathology, Roswell Park Cancer Institute, Buffalo, NY, USA

    Paul Bogner MD

  6. Department of Thoracic Surgery, Roswell Park Cancer Institute, Buffalo, NY, USA

    Chukwumere E. Nwogu MD, Todd L. Demmy MD & Sai Yendamuri MD, FACS

  7. Department of Surgery, State University of New York, Buffalo, NY, USA

    Chukwumere E. Nwogu MD, Todd L. Demmy MD & Sai Yendamuri MD, FACS

Authors
  1. Moshim Kukar MD
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  2. Adrienne Groman MS
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  3. Usha Malhotra MD
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  4. Graham W. Warren MD
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  5. Paul Bogner MD
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  6. Chukwumere E. Nwogu MD
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  7. Todd L. Demmy MD
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  8. Sai Yendamuri MD, FACS
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Correspondence to Sai Yendamuri MD, FACS.

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Kukar, M., Groman, A., Malhotra, U. et al. Small Cell Carcinoma of the Esophagus: A SEER Database Analysis. Ann Surg Oncol 20, 4239–4244 (2013). https://doi.org/10.1245/s10434-013-3167-3

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  • DOI: https://doi.org/10.1245/s10434-013-3167-3

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