Effect on survival of postoperative therapy in patients with primary small cell carcinoma of esophagus (SCCE): An analysis of multicenter clinical outcomes.

Abstract

e14648 Background: To retrospectively evaluate the therapy pattern and survival in patients with dissection of primary SCCE. Methods: This study included 89 patients from four centers in southwest China who underwent radical section of SCCE without any preoperative therapy. 36 were treated with postoperative chemoradiotherapy (POCRT), and 53 with postoperative chemotherapy (POCT) alone. The radiation dose to clinical target volume (CTV) was 50 Gy (varying between 44 and 52 Gy), while the cycles of platinum-based chemotherapy ranged from two to six with a median of four. Results: The 5-year overall survival rate (OS) and 5-year disease-free survival rate (DFS) were 16.4% and 14.3% for all patients,respectively. The 5-year overall survival rate was 21.5% in the POCRT group, and 12.9% in the POCT group (p=0.013). The 5-year DFS was 21.3% in POCRT group and 9.3% in POCT group (p=0.028). There was significant difference in 5-year local recurrence-free survival (LRFS) between POCRT and POCT (LRFS: 74.6% vs. 45.3%, p=0.022), while no difference for 5-year distant recurrence-free survival (DRFS: 37.3% vs. 17.4%, p=0.101). Subgroup analysis revieled that there were obvious difference in 5-year OS and DFS between patients received radiotherapy less than 75 days after surgery and ≥ 75 days (OS: 35.6% vs. 8.6%, p=0.046; DFS: 24.9% vs. 7.3%, p=0.020), while received radiotherapy less than 75 days after surgery have worse DRFS (p=0.041). In a multivariate analysis, age ≥59 years was associated with significantly worse OS while with lymph node involved infulence DFS. Tumor size more than 3cm, absence of radiotherapy and less than 4 cycles chemotherapy were poor prognostic factors for both overall survival and disease-free survival. Conclusions: Our analysis shows that postoperative chemotherapy improved OS and DFS in patients with dissection of SCCE, while radiotherapy was given less than 75 days after surgery may improve DRFS and OS. In those patients received postoperative chemotherapy less than 4 cycles is the most important characteristic associated with decreased survival.