title: Prognostic factors in extrapulmonary small cell carcinomas. A large retrospective study.
abstract: 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.
authors: Department of Internal Medicine, Division of Hematology-Oncology, Changhua Christian Hospital, Changhua, Taiwan.
authors: Yu-Lin
authors: YL
authors: Lin
authors: Chih-Yuan
authors: CY
authors: Chung
authors: Cheng-Shyong
authors: CS
authors: Chang
authors: Jia-Shing
authors: JS
authors: Wu
authors: Kuan-Ting
authors: KT
authors: Kuo
authors: Sung-Hsin
authors: SH
authors: Kuo
authors: Ann-Lii
authors: AL
authors: Cheng
mesh_terms: 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