Prognostic factors in extrapulmonary small cell carcinomas. A large retrospective study.
BACKGROUND
Extrapulmonary small cell carcinoma (EPSCC) is a heterogeneous group of cancers. The clinicopathological features of EPSCC remain poorly defined.


METHODS
Patients with the clinicopathological features of EPSCC, treated at three major medical centers in Taiwan, were included. Histologic and clinical diagnoses, smoking history, staging, clinical course and treatment outcome were reviewed and analyzed.


RESULTS
A total of 90 patients, treated between 1995 and 2005, were eligible for analysis. Forty-nine patients had limited disease and 41 extensive disease. Ten, 18, 17 and 45 patients received no treatment, local treatment, chemotherapy alone or combined modality treatment, respectively; the median survival for these four groups was 1.1, 13.8, 6.7 and 24.9 months. The origin of cancer was head and neck in 17, gastrointestinal in 27, genitourinary in 10, gynecologic in 27 and unknown in 9 patients; the median survival time was 34.2, 6.4, 9.1, 23.7 and 9.2 months, respectively. Ten out of 90 patients were long-term survivors, and 9 of them had tumors of head-and-neck and gynecologic origin. There was no statistically significant difference in survival between smokers and non-smokers. Factors associated with survival in univariate analysis included age < or =60, female gender, limited disease, head-and-neck and gynecologic origin, as well as combined modality treatment. However, in multivariate analysis, only female gender, limited disease and combined modality treatment were independent predictors of survival.


CONCLUSIONS
Female gender, limited disease and combined modality treatment are favorable prognostic factors for patients with EPSCC. Prolonged survival is more likely in patients with tumors of head-and-neck and gynecologic origin.
Lin
Yu-Lin
YL
Department of Internal Medicine, Division of Hematology-Oncology, Changhua Christian Hospital, Changhua, Taiwan.
Chung
Chih-Yuan
CY
Chang
Cheng-Shyong
CS
Wu
Jia-Shing
JS
Kuo
Kuan-Ting
KT
Kuo
Sung-Hsin
SH
Cheng
Ann-Lii
AL
D018288:Carcinoma, Small Cell / Q000401:mortality* / Q000628:therapy; D005260:Female; D005833:Genital Neoplasms, Female / Q000401:mortality* / Q000628:therapy; D006258:Head and Neck Neoplasms / Q000401:mortality* / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D016019:Survival Analysis