Extrapulmonary small cell carcinoma of lymph node: Pooled analysis of all reported cases

Table 1 Details of studies included in the review

Ref.	No. of patients	Gender	Age	Stage	Lymph node area involved	Investigations performed to rule out primary elsewhere	Treatment regimen used	No. of cycles received	Response	Complication of treatment	PFS, in months	Overall survival, in months	Site of relapse	Final outcome
Levenson et al[23]	1	Male	49	LD	Cervical	CXR, FB, radionuclide scan of liver, bone, spleen and brain	CMC-VAP + local RT	NA	CR	NA	15+	15+	None	Alive with disease
Kasimis et al[22]	2	Male	60	ED	Right submandibular	CXR, panendoscopy of larynx, pharynx, bronchial tree and esophagus	Surgery (radical neck dissection) + RT (5860 rads); cyclophosphamide and doxorubicin + cranial irradiation	NA	SD	None	24	36	Left cervical LN, left scapular region, left parotid gland, left submandibular LN, right tonsil, right testis	Died of disease
		Male	70	ED	Right submandibular and posterior cervical	CXR, sputum cytology, bone and liver scan, panendoscopy of larynx, pharynx, bronchial tree and esophagus	None (patient refused treatment)	-	SD	None	18+	40+	Locoregional enlargement of submandibular LN at 18 mo	Alive with disease
Remick et al[21]	1	Male	52	LD	Left cervical LN	CXR, CECT thorax and abdomen, bone scan	RT (46 Gray)	NA	CR	None	NA	84+	None	Alive with disease
Hainsworth et al[20]	2	Female	77	LD	Inguinal	CXR, CECT thorax and abdomen	Surgery	-	CR	None	12+	12+	None	Alive with disease
		Male	61	LD	Cervical	CXR, CECT thorax and abdomen, bone scan	CAV + RT	NA	CR	NA	100+	100+	None	Alive with disease
Van Der Gaast et al[19]	2	NA	55 (26-72)	LD	Cervical LN	CXR, CECT thorax and abdomen, bone scan	CDE (iv cyclophosphamide 1 g/sq.m on day 1, iv doxorubicin 45 mg/sq.m on day 1 and iv etoposide 100 mg/sq.m on days 1, 3 and 5)	Five	CR	Hematological (grade 3-4 leukopenia, neutropenia, thrombocytopenia), nausea and vomiting, alopecia	NA	22+	Locoregional	Alive with disease
		NA	55 (26-72)	LD	Cervical LN	CXR, CECT thorax and abdomen, bone scan	CDE (iv cyclophosphamide 1 g/sq.m on day 1, iv doxorubicin 45 mg/sq.m on day 1 and iv etoposide 100 mg/sq.m on days 1, 3 and 5) + RT (6000 cGy)	Five	CR	Hematological (grade 3-4 leukopenia, neutropenia, thrombocytopenia), nausea and vomiting, alopecia	12+	12+	None	Alive with disease
Galanis et al[18]	4	NA	NA	LD	Submandibular LN	CXR, CECT thorax and abdomen, bone scan	Surgery	Nil	CR	None	42+	42+	None	Alive at with disease
		NA	NA	LD	Submandibular LN	CXR, CECT thorax and abdomen, bone scan	Surgery	Nil	CR	None	42+	42+	None	Alive with disease
		NA	NA	LD	Inguinal	CXR, CECT thorax and abdomen, bone scan	Surgery	Nil	CR	None	42+	42+	None	Alive with disease
		NA	NA	ED	Submandibular	CXR, CECT thorax and abdomen, bone scan	NA	NA	NA	None	NA	42+	None	Alive with disease
Orhan et al[17]	1	Male	55	ED	Right cervical LN and multiple cranial metastasis	CXR, CT (thorax and abdomen), FB	Etoposide (100 mg/sq.m on days 1, 3, 5) and cisplatin (80 mg/sq.m on day 1)	Six	CR	None	7	7+	None	Alive with disease
Ochsenreither et al[16]	1	Male	68	LD	Cervical LN	CECT thorax and FB	Surgery and RT	-	CR	None	5	22	NA	Died of disease
Current report	3	Male	59	LD	Unilateral LN (left cervical LN)	CXR, CECT, neck, thorax and abdomen, FB	Irinotecan (100 mg/sq.m) and cisplatin (60 mg/sq.m) each on D1 of 3 weekly cycle	6 (3 weekly)	CR	None	9	16+	Locoregional	Alive with disease
		Male	38	ED	Bilateral cervical LNs	CXR, CECT thorax and abdomen and whole body PET CT	Irinotecan (65 mg/sq.m) and cisplatin (30 mg/sq.m) each on D1 and D8 of 3 weekly cycle	1 (C1D1)	NR	Grade IV hematological (pancytopenia), deranged liver enzymes	Not assessable	1	Systemic	Died of disease
		Female	65	ED	Right sided submandibular and cervical LNs	CXR, CECT neck, thorax, abdomen and; CT head	Irinotecan (65 mg/sq.m) and cisplatin (30 mg/sq.m) each on D1 and D8 of 3 weekly cycle	4 (twice weekly; C1D1 and C1D8)	PR	Nausea and vomiting, constipation (grade II) and grade II hematological (anaemia and leucopenia)	7	13	Increase in cervical LN size and skull bone metastasis with invading the bone	Died of disease

CAV: Cyclophosphamide, doxorubicin and vincristine; CDE: Cyclophosphamide, doxorubicin, etoposide; CMC-VAP: Cytoxan, methotrexate, CCNU [1-(2-chlorethyl)-3-cyclohexyl-1-nitrosourea] alternating with vincristine, adriamycin, and procarbazine; CECT: Contrast enhanced computed tomography; CR: Complete response; CXR: Chest radiograph; FB: Flexible bronchoscopy; ED: Extensive disease; LD: Limited disease; LN: Lymph node; NA: Not available; PR: Partial response; RT: Radiotherapy; SD: Stable disease.