Outcome Of Small Cell Carcinoma Research Articles

Clinical Outcomes of Small Cell Carcinoma of the Genitourinary Tract and the Prognostic Significance of the Tumor Immune Microenvironment.

Small cell carcinoma of the genitourinary tract (GU SCC) is a rare disease with a poor prognosis. There are only limited treatment options due to insufficient understanding of the disease. In this study, we analyzed the clinical outcomes of patients with GU SCC and their association with the tumor immune phenotype. Patients diagnosed with GU SCC were included. Survival outcomes according to the primary location (prostate and non-prostate) and stages (limited disease [LD] and extensive disease [ED]) were analyzed. We performed multiplex immunohistochemistry (IHC) in non-prostate SCC patients and analyzed the immune cell population. A total of 77 patients were included in this study. Their median age was 71 years, 67 patients (87.0%) were male, and 48 patients (62.3%) had non-prostate SCC. All patients with ED (n=31, 40.3%) received etoposide plus platinum (EP) as initial treatment and median overall survival (OS) was 9.7 months (95% confidence interval [CI], 7.1 to 18.6). Patients with LD (n=46, 59.7%) received EP followed by radiotherapy or surgery, and 24-months OS rate was 63.6% (95% CI, 49.9 to 81.0). The multiplex IHC analysis of 21 patients with non-prostate SCC showed that patients with a higher density of programmed death-ligand 1-expressing CD68+CD206+ M2-like macrophages had significantly worse OS outcomes with an adjusted hazards ratio of 4.17 (95% CI, 1.25 to 14.29; adjusted p=0.02). Patients with GU SCC had a poor prognosis, even those with localized disease. The tumor immune phenotypes were significantly associated with survival. This finding provides new insights for treating GU SCC.

Clinical Outcomes of Small Cell Carcinoma of Bladder: A Single Institutional Experience

Clinical Outcomes of Small Cell Carcinoma of Bladder: A Single Institutional Experience

The oncological outcomes of small cell carcinoma of the bladder.

Small cell carcinoma of the bladder (SmCC) is a rare and aggressive genitourinary malignancy. The paucity of clinical trials and outcome data provide no standard treatment guidelines. Accordingly, patient prognosis is poor. Our goal was to present the first comprehensive in-depth analysis of SmCC in a tertiary Canadian centre. We retrospectively reviewed all patients diagnosed with primary SmCC at the London Regional Cancer Program between January 1990 and 2016. The primary outcome was overall survival (OS). We examined a number of secondary outcomes and baseline characteristics. We identified 15 men and six women (median age 72 years) with a SmCC diagnosis (median followup 11.33 months). Median Charlson Comorbidity Index score was 7 (interquartile range [IQR] 5-10) and 15 patients had a smoking history. Most common presentation was gross hematuria (18 patients, 86%), and pT2 stage at transurethral resection of the bladder tumour (TURBT) (n= 7/21, 33%), although five patients had cT4 (24%). Pure SmCC was found in nine individuals (43%), whereas 12 had mixed differentiation (57%). From initial staging, 15 patients had extravesical disease (71%), 10 had positive pelvic lymphadenopathy (48%), and distant metastases occurred in six (29%). In our series, five individuals (24%) underwent cystectomy, 18 (86%) received radiation, and 14 (67%) received adjuvant chemotherapy. The median OS was 15 months (two-year OS was 19%). SmCC is a rare and aggressive form of bladder cancer. Despite multimodal therapy, prognosis remains guarded, with little improvement seen over the study's 25-year duration. An understanding of study limitations is warranted in interpretation of results.

188P - Outcome of small cell carcinoma of esophagus: An institutional experience from North-East India

188P - Outcome of small cell carcinoma of esophagus: An institutional experience from North-East India

Treatment and survival outcomes of small cell carcinoma of the esophagus: an analysis of the National Cancer Data Base.

Given the paucity of esophageal small cell carcinoma (SCC) cases, there are few large studies evaluating this disease. In this study, the National Cancer Data Base (NCDB) was utilized to analyze the clinical features, treatment, and survival of patients with esophageal SCC in a large, population-based dataset. We selected patients diagnosed with esophageal SCC from 1998 to 2011. Patients were identified as having no treatment, chemotherapy alone, radiation ± sequential chemotherapy, concurrent chemoradiation, and esophagectomy ± chemotherapy and/or radiation. Overall survival (OS) was analyzed using the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox regression analysis was conducted to identify factors associated with OS. A total of 583 patients were identified. Most patients had stage IV disease (41.7%). Regarding treatment selection, chemoradiation was the most commonly utilized for patients with nonmetasatic disease, whereas chemotherapy alone was most common for metastatic patients. Esophagectomy (median survival 44.9months with 3year OS 50.5%) was associated with the best OS for patients with localized (node-negative) disease compared with chemotherapy alone (p < 0.001) or chemoradiation (p = 0.01). For locoregional (node-positive) disease, treatment with chemoradiation resulted in a median survival of 17.8months and a 3year OS 31.6%. On multivariate analysis, treatment with chemotherapy alone (p = 0.003) was associated with worse OS while esophagectomy (p = 0.04) was associated with improved OS compared to chemoradiation. Esophageal SCC is an aggressive malignancy with most patients presenting with metastatic disease. Either esophagectomy or chemoradiation as part of multimodality treatment appear to improve OS for selected patients with nonmetastatic disease.

Pulmonary neuroendocrine tumors: Study of 90 cases focusing on clinicopathological characteristics, immunophenotype, preoperative biopsy, and frozen section diagnoses

Pulmonary neuroendocrine tumors have a prognostic spectrum including typical carcinoid (TC), atypical carcinoid (AC), small cell carcinoma (SCLC), and large cell neuroendocrine carcinoma (LCNEC). We conducted a retrospective study to compare their clinicopathological characteristics, immunophenotype, preoperative biopsy and frozen section diagnoses, and prognosis. Ninety cases of surgically treated pulmonary neuroendocrine tumors were studied. Immunohistochemical studies were performed using antibodies to chromogranin A, synaptophysin, and CD56. The preoperative biopsy and frozen section diagnoses were reviewed. The 5-year survival rates for TC, AC, SCLC, and LCNEC were 96.6%, 66.7%, 42.4%, and 38.0%, respectively. T stage and pleural status correlated with outcome of SCLC and LCNEC, but N-stage and overall TNM stage did not. In preoperative biopsy, accurate diagnosis was achieved in 5 of 11 TC, 2 of 4 AC, 6 of 15 SCLC, and 0 of 5 LCNEC cases. Using frozen sections, accurate diagnosis was achieved in 8 of 12 TC, 2 of 11 SCLC, and 0 of 11 LCNEC cases. LCNEC was the most difficult to diagnose using either preoperative biopsy or frozen sections. T stage and pleural status can predict outcome of SCLC and LCNEC.

Characterization and Outcomes of Small Cell Carcinoma of the Bladder Using the Surveillance, Epidemiology, and End Results Database

To utilize the Surveillance, Epidemiology, and End Results Database to analyze clinical features, treatment, and survival outcomes of patients with small cell carcinoma of the bladder in a large population-based sample. Because of its rarity, prior reports are primarily limited to small single-institution studies. We identified patients of any age who were diagnosed with small cell carcinoma of the bladder between 1988 and 2007. Kaplan-Meier and Cox regression analysis were used to compare overall survival (OS) and urinary bladder-specific survival. A total of 663 patients were identified. Most patients had either stage II (38.8%) or stage IV (35.4%) disease. The median OS for all patients was 12 months [95% confidence interval (CI), 10.9-13.1]. After excluding those patients who presented with distant metastatic disease or for whom it was unknown whether or not they received any treatment, there were no significant differences in survival between those that received cystectomy (median survival, 21 mo; 95% CI, 14.3-27.7) compared with those who underwent external beam radiation (median survival, 17 mo; 95% CI, 13.4-20.6). On multivariate analysis, both cystectomy (hazard ratio, 0.53; 95% CI, 0.4-0.71; P < 0.001) and radiation (hazard ratio, 0.66; 95% CI, 0.5-0.88; P=0.005) were associated with improved survival. Small cell carcinoma of the bladder is a rare but aggressive malignancy with poor OS. For those who present without widespread metastatic disease, treatment with either cystectomy or radiation appears to improve survival. Further prospective studies are needed to determine the best approach for treatment of these patients.

Characterization and Outcomes of Small Cell Carcinoma of the Bladder using the Surveillance, Epidemiology and End Results Database

To utilize the Surveillance, Epidemiology, and End Results Database in order to analyze clinical features, treatment and survival outcomes of patients with small cell carcinoma of the bladder in a large population-based sample. Due to its rarity, prior reports are primarily limited to small single-institution studies.