3444 - Outcomes of Extensive-Stage Small-Cell Esophagus Cancer Patients Treated with Different Treatment Modalities: A Multi-Institutional Retrospective Analysis

02:30pm - 03:45pm PT

Hall F

Screen: 8

Presenter(s)

Wei Huang, PhD - Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, jinan,

W. Huang¹, and X. Liu²; ¹Department of Radiation Oncology, Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, China, ²Department of Radiation Oncology, Shandong Cancer Hospital andInstitute, Shandong First Medical University and Shandong Academy of Medical Sciences, Jinan, Shandong, China., Jinan, China

Purpose/Objective(s):

Small cell carcinoma of the esophagus (SCCE) is a rare but highly aggressive neuroendocrine malignancy. Despite its rarity, SCCE is characterized by rapid progression, early metastasis, and poor prognosis, particularly in the extensive-stage disease. This study aimed to investigate the treatment, outcomes, and risk factors impacting on survival endpoints in patients with extensive -stage SCCE (ES- SCCE).

Materials/Methods:

Consecutive patients with ES- SCCE from 16 institutions between 2000 to 2022 in China were enrolled. Survival curves were constructed using the Kaplan-Meier method and compared by log-rank test. Univariate and multivariate Cox regression models and propensity score matching (PSM) analysis were adopted in prognostic analysis. Results were reported as hazard ratio (HR), 95% confidence interval (CI), and P value. Statistical significance was set as P value < 0.05 in a two-tailed test

Results:

A total of 196 patients were included,including 143 (72.9%)males. Among them, 50 (25.5%)patients received either immunotherapy combined with chemoradiotherapy or chemotherapy alone, 75(38.2%) patients underwent radiotherapy combined with chemotherapy, and 91(46%)patients received chemotherapy only. The median follow-up time was 64.7 months. The median overall survival (OS) time and the 2-year OS rate were 16.1 months and 22.24%, respectively.

Multivariate analysis showed that T stage(HR: 1.384, 95% CI: 1.018–1.882 ,p=0.038),numbers of chemotherapy cycles(HR: 0.423, 95% CI: 0.201–0.891 ,p=0.0024), and whether the patient received immunotherapy (HR: 0.384, 95% CI: 0.188–0.782 ,p=0.008)were independent prognostic factors for OS, and radiotherapy did not improve patients' OS or progression-free survival (PFS) after PSM analyses. Compared to patients who received 2-4 cycles of systemic chemotherapy, those who underwent more than 4 cycles of chemotherapy had better overall survival after PSM analyses.

In survival analysis, patients who received immunotherapy had significantly higher 1-year (88.57% vs 48.9%,p<0.005) and 2-year survival rates (51.4% vs 17.3%,p<0.001) compared to those who have not receive immunotherapy. The median OS was 26.16 months for patients receiving immunotherapy, and was 13.67 months for patients without immunotherapy (p<0.001).

Conclusion:

An early T stage, numbers of chemotherapy cycles and multimodality treatments were identified as independent prognostic factors of ES- SCCE, whereas immunotherapy was associated with improved survival.