Abstract
7075 Background: Extrapulmonary small cell carcinoma (EPSCC) is a rare cause of malignancy, with an incidence of approximately 1,000 cases per year. Overall survival (OS) in EPSCC is poor with median survival of 9.8 months in extensive disease (ED) and 34 months in limited disease (LD). Further characterization of EPSCC, prognostic factors, and response to treatment is critical for future management of this tumor type in a more heterogeneous population such as in the Texas Medical Center. Methods: Charts of 53 cases of EPSCC between 2000-2010 within the 3 affiliated hospitals of Baylor College of Medicine were reviewed. Univariate survival analysis was perfomed on dichotomized clinical and demographic data and represented as Kaplan-Meier curves. Multivariate analysis was performed utilizing Cox proportional-hazards regression model. Results: Cases of EPSCC were stratified based on organ system and stage, and were computed as shown in the table. ED (p=0.001), sodium <138 (p=0.02), and nongenitourinary (GU) EPSCC (p=0.04) were all significant predictors of OS on a univariate analysis. In a multivariate analysis, ED was statistically significant in predicting OS (p=0.014). Non-GU EPSCC was more likely to be ED at diagnosis than GU EPSCC (p=0.027). Conclusions: Unique to our study, GU EPSCC was more common than in previous reviews. Additionally, non-GU EPSCC was noted to be a poor predictor of OS and had worse survival than in previous series. Disease stage also negatively predicted OS. In our population, hyponatremia was associated with poor prognosis; which is intriguing given that it has been associated with poorer prognosis in small cell lung cancer. Prospective data is needed to further evaluate these trends. Disease location No. of patients (%) Limited disease (%) Extensive disease (%) Median survival (months) GU 14 (26) 13.1 Kidney 1 1 0 Bladder 11 9 2 Prostate 2 0 2 GI 8 (15) 1.7 Esophagus 2 1 1 Stomach 1 0 1 Pancreas 3 0 3 Gallbladder 1 0 1 Colon 1 0 1 Head and Neck 6 (11) 4 Larynx 2 1 1 Pharynx 1 0 1 Thyroid 1 1 0 Salivary glands 2 1 1 CUP 21 (40) 1.5 Liver 5 3 2 Lymph nodes 1 0 1 Other 15 3 12 Breast 1 (2) 1 0 73 Gyn 3 (6) 12.8 Cervix 3 2 1 Total 53 (100) 23 (43) 30 (57) 4.7 (0.3-99) Median survival p=0.001 14.5 3.7 Abbreviation: CUP, carcinoma of unknown primary.
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