Systematic Reviews
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Jun 10, 2016; 7(3): 308-320
Published online Jun 10, 2016. doi: 10.5306/wjco.v7.i3.308
Extrapulmonary small cell carcinoma of lymph node: Pooled analysis of all reported cases
Inderpaul Singh Sehgal, Harpreet Kaur, Sahajal Dhooria, Amanjit Bal, Nalini Gupta, Digambar Behera, Navneet Singh
Inderpaul Singh Sehgal, Harpreet Kaur, Sahajal Dhooria, Digambar Behera, Navneet Singh, Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Amanjit Bal, Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Nalini Gupta, Department of Cytology and Gynecological Pathology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
Author contributions: Sehgal IS collected patient data, systematic review, drafted and revised the manuscript; Kaur H collected patient data, drafted and revised the manuscript; Dhooria S drafted and revised the manuscript; Bal A and Gupta N interpreted and reported pathological specimens of index cases, drafted and revised the manuscript; Behera D managed index cases, revised the manuscript; Singh N managed index cases, conceived the idea, systematic review, drafted and revised the manuscript.
Conflict-of-interest statement: None.
Data sharing statement: The technical appendix, statistical code, and dataset are available from the corresponding author at navneetchd@yahoo.com.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Correspondence to: Dr. Navneet Singh, MD, DM, Associate Professor, Department of Pulmonary Medicine, Postgraduate Institute of Medical Education and Research, Sector-12, Chandigarh 160012, India. navneetchd@yahoo.com
Telephone: +91-172-2756826 Fax: +91-172-2748215
Received: February 1, 2016
Peer-review started: February 2, 2016
First decision: March 21, 2016
Revised: March 28, 2016
Accepted: April 14, 2016
Article in press: April 18, 2016
Published online: June 10, 2016
Abstract

AIM: To study clinical outcomes and management of lymph nodes extrapulmonary small cell carcinoma (LNEPSCC).

METHODS: Herein, we perform a systematic search of published literature in the PubMed and EMBASE databases for studies describing LNEPSCC. For uniformity of reporting, LNEPSCC was staged as limited if it involved either single lymph node station or if surgery with curative intent had been undertaken. The disease was staged extensive if it involved two or more lymph node regions.

RESULTS: The systematic literature review yielded eight descriptions (n = 14) involving cervical, submandibular and inguinal lymph nodes. Eleven (64.7%) patients had limited disease (LD) and six (35.3%) had extensive disease (ED) at presentation. Chemotherapy (n = 6, 35.3%) or surgery (n = 4, 23.5%) were the most common form of treatment given to these patients. Complete response was achieved in 12 (70.6%) of the patients. Median (interquartile range) progression free survival and overall survival was 15 (7-42) mo and 22 (12.75-42) mo respectively. Of the three illustrative cases, two patients each had ED at presentation and achieved complete remission with platinum based combination chemotherapy.

CONCLUSION: LNEPSCC is a rare disease with less than 15 reported cases in world literature. Surgical resection with curative intent is feasible in those with LD while platinum based combination chemoradiation is associated with favorable outcomes in patients with ED. Prognosis of LNEPSCC is better than that of small cell lung cancer in general.

Keywords: Extrapulmonary, Small cell, Carcinoma, Lymph node, Small cell lung cancer

Core tip: Extrapulmonary small cell cancer confined to lymph nodes (LNEPSCC) is extremely rare. A systematic literature review yielded 3 index and 14 previous case descriptions. Chemotherapy or surgery was most common treatments given with complete response achieved in 70% of the cases. Surgical resection with curative intent is feasible in those with limited disease. Prognosis of LNEPSCC is better than that of small cell lung cancer in general.