Takeaway
- The majority of patients with nonmetastatic esophageal small cell carcinoma (ESCC) are treated with chemoradiotherapy (CRT), according to the largest study to date on the rare cancer.
- Compared with chemotherapy alone, adding surgery or radiotherapy was associated with better OS.
Why this matters
- National guidelines offer no consensus on the optimal treatment regimen for ESCC, and research on the best therapy has yielded conflicting results.
Study design
- 323 patients with newly diagnosed, nonmetastatic ESCC from the National Cancer Database.
- Funding: None disclosed.
Key results
- 20% underwent surgical-based treatment, 65% CRT, and 15% chemotherapy alone.
- No difference in OS between the surgery-based and CRT groups, but both had better OS than chemotherapy alone (P<.001>
- Median OS for the surgery-based group was 21 (95% CI, 16-33) months vs 18 (95% CI, 15-23) months for CRT, and 10 (95% CI, 6-12) months for chemotherapy alone.
- After multivariable analysis, receipt of additional local therapy (surgery or radiotherapy) was an independent predictor of better OS (P<.001 and older age increasing t n classification treatment at a community facility residence in an area with lower educational status were all independently associated poorer os for>
Limitations
- Retrospective study.
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