Small cell carcinoma of the oesophagus: experience of an Indian Tertiary Cancer Centre

Goutam Santosh Panda; Vanita Noronha; Subhash Yadav; Amit Joshi; Vijay Patil; Nandini Menon; Rajiv Kumar; Amit Janu; Abhishek Mahajan; Nilendu Purandare; Jai Prakash Agarwal; George Karimundackal; Kumar Prabhash

doi:10.3332/ecancer.2022.1393

Small cell carcinoma of the oesophagus: experience of an Indian Tertiary Cancer Centre

Ecancermedicalscience. 2022 May 19:16:1393. doi: 10.3332/ecancer.2022.1393. eCollection 2022.

Affiliations

¹ Department of Medical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400012, India.
² Department of Pathology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400012, India.
³ Department of Radiodiagnosis, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400012, India.
⁴ Department of Nuclear Medicine, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400012, India.
⁵ Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400012, India.
⁶ Department of Surgical Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai 400012, India.

Abstract

Introduction: Small cell carcinoma of the oesophagus (SCCE) is a rare and aggressive tumour with no established standard treatment.

Methods: This is a retrospective study of adult patients with histologically proven SCCE registered between February 2011 and March 2020 at Tata Memorial Hospital in Mumbai.

Results: There were 56 patients, with 29 (51.8%) having limited-stage disease (LD) and 27 (48.2%) having extensive-stage disease (ED). The median age was 58 (interquartile range = 51-65) years; 57.1% were men; and 40% were smokers. Among LD-SCCE patients, 23 underwent local therapy, i.e., radiation (19, 65.5%) and surgery (4, 13.8%), and 27 received chemotherapy in neoadjuvant (23, 79.3%), concurrent (18, 62.1%) and adjuvant (4, 13.8%) settings. Totally, 19 ED-SCCE patients (70.4%) received chemotherapy. Prophylactic cranial irradiation (PCI) was delivered to 11 (37.9%) and 7 (25.9%) patients with LD-SCCE and ED-SCCE, respectively. Signiﬁcant grade 3 or more chemotoxicities in patients with LD-SCCE and ED-SCCE included febrile neutropenia in 33.3% and 23.5%, anaemia in 9.5% and 17.6%, and dyselectrolytemia in 14.3% and 11.8%, respectively. The median overall survival (OS) in LD-SCCE and ED-SCCE was 22.9 (95% CI = 1.8-44.1) months and 11.8 (95% CI = 7.3-16.4) months, respectively. Age <60 years (p = 0.004) and tumour epicentre in the lower third oesophagus (p = 0.002) were independent good prognostic factors for OS in LD-SCCE and ED-SCCE patients, respectively. The incidence of brain metastasis was low, at both presentation (1/27, 3.7%) and relapse (5/56, 8.9%).

Conclusion: Although the survival of LD-SCCE is better than ED-SCCE, it is still under 2 years. Brain metastases are uncommon and the role of PCI is uncertain.

Keywords: outcome; small cell carcinoma of the oesophagus; systemic therapy; toxicity.