Retrospective Cohort Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Oct 24, 2020; 11(10): 836-843
Published online Oct 24, 2020. doi: 10.5306/wjco.v11.i10.836
Primary small cell oesophageal carcinoma: A retrospective study of different ‎treatment modalities
Mohammad Alfayez
Mohammad Alfayez, Faculty of Medicine, Umm Al-Qura University, Makkah 21514, Saudi Arabia
Mohammad Alfayez, King Abdullah Medical City, Makkah 21514, Saudi Arabia
Mohammad Alfayez, Beatson West of Scotland Cancer Centre, Glasgow G12 0YN, United Kingdom
Author contributions: Alfayez M collected and analyzed the data, wrote the manuscript, read and approve the final manuscript.
Institutional review board statement: NHS Greater Glasgow and Clyde Ethics Committee has reviewed the research proposal for the study title primary small oesophageal cancer: A retrospective study of different modalities of treatment. The study is a historical cohort which was looking at the outcomes of patients with small cell of oesophagus who were treated at the Beatson West of Scotland Cancer Centre. There was no requirement to obtain ethical approval for such historical study.
Informed consent statement: Consent was not obtained but the presented data are anonymized and risk of identification is low.
Conflict-of-interest statement: The author has no conflict of interest related to the manuscript.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at malfayez@nhs.net. No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Mohammad Alfayez, MD, PhD, Assistant Professor, Faculty of Medicine, Umm Al-Qura University, Alabdeh campus, Makkah-Taif Road, Makkah 21514, Saudi Arabia. malfayez@nhs.net
Received: June 16, 2020
Peer-review started: June 16, 2020
First decision: July 25, 2020
Revised: July 29, 2020
Accepted: September 11, 2020
Article in press: September 11, 2020
Published online: October 24, 2020
Abstract
BACKGROUND

Primary small cell of esophageal carcinoma is an aggressive tumor with no established treatment guidelines. A treatment strategy was adopted based on small cell carcinoma of the lung because of many similar clinicopathological features. Here, we report one of the largest case series in a western population.

AIM

To review the practice of treating small cell oesophageal cancer (SCOC) with different treatment modalities treated at our institution between 2001 and 2014.

METHODS

A total of 28 cases of SCOC have been identified. All cases were identified with a ten-digit code known as the CHI number. Data was collected using a combination of an electronic database, case notes and the chemotherapy electronic prescribing system (chemocare). We collected information on age, gender, performance status, staging of the disease (limited stage vs extensive stage).

RESULTS

The results showed 17 patients (61%) were diagnosed with limited stage small cell oesophageal cancer (LS-SCOC), while 11 patients (39%) were diagnosed with extensive stage small cell oesophageal cancer (ES-SCOC). The median age at diagnosis of SCOC was 72 years (range 52-86). The median survival for patients with ES-SCOC was 7 mo (95%CI: 1-12) vs LS-SCOC [median 23 mo (95%CI: 14-40)], P < 0.0001. Subgroup analysis of those who received treatment showed the median survival for patients who received palliative chemotherapy was 7 mo (95%CI: 1.5-12), concurrent chemoradiation 45 mo (95%CI: 38-) and sequential chemoradiation 20 mo (95%CI: 17-25), P < 0.0001.

CONCLUSION

Our data strongly support the use of concurrent chemoradiation in the treatment of LS-SCOC in patients who are fit with no significant comorbidity.

Keywords: Chemotherapy, Chemoradiotherapy, Small cell carcinoma, Oesophageal cancer, Pallaitive chemotherapy, Radiotherapy

Core Tip: Primary small cell oesophageal carcinoma is rare, prognosis is poor and there is no established ‎optimum treatment strategy. Here, we report largest case series in western world. Our data strongly ‎support the use of concurrent chemoradiation in the treatment of limited stage of small cell carcinoma of ‎the oesophagous in patients who are fit with no significant comorbidity.