Outcome of Primary Small Cell Carcinoma of Esophagus: A Single Institutional Experience

Abstract

Background: Background and Objectives: Primary small cell carcinoma of esophagus (SCCE) is a very aggressive disease and accounts for 0.8–3.1% of all esophageal cancers. The study analysed clinical characteristics and survival outcome of 24 treated cases. Subjects & Methods: Out of total 3,440 cases of esophageal cancers diagnosed from 2013 to 2016 at Dr B Borooah Cancer Institute, clinical data were obtained from 24 histologically and immunohistochemically confirmed cases of primary SCCE. Patients received surgery, chemotherapy and/or radiotherapy, either alone or in combinations. Results: The median age of patients was 54 years with male preponderance. Out of 24 cases, 15 cases have pure small cell carcinoma histology and 9 cases had mixed pathology (poorly differentiated carcinoma with neuroendocrine differentiation). The median overall survival time was 14 months. The 6-, 12-, 24- and 36- month’s survival rates of these patients were 91.6%, 54.1%, 33.3% and 25.0% respectively. The 3-year survival rate for patients with localised disease was 62.6% vs. 6.3% for those with metastatic disease (p=0.007). Nine patients had relapses within first 6 months from the completion of any therapy. Patients with pure small cell carcinoma histology (vs. mixed histology, p=0.008), with distant organ involvement (vs. no organ involvement, p=0.022) and those who are non-responders to treatment (vs. responders, p<0.0001) were correlated with shorter overall survival in univariate analysis. Conclusion: Primary SCCE presents with early metastasis and have a poor prognosis, with the existing modalities of treatment. Combined therapy based on platinum-based combination chemotherapy may improve the short term survival in these patients.