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Published on: February 12, 2017
Patterns of relapse in extrapulmonary small cell carcinoma: retrospective analysis of outcomes from two cancer
S Gennatas1, J Noble2, S Stanway2
1Faculty of Medicine, National Heart and Lung Institute, Imperial College London, London, UK Department of Medicine, Royal Marsden Hospital, London, UK.
Objectives:
We conducted a retrospective review of patients with extrapulmonary small cell carcinomas (EPSCCs) to explore the distribution, treatments, patterns of relapse and outcomes by primary site.
Setting:
We have reviewed the outcomes of one of the largest data sets of consecutive patients with EPSCC identified from two major cancer centres.
Participants:
Consecutive patients with a histopathological diagnosis of EPSCC from the two institutions were retrospectively identified.
Primary And Secondary Outcome Measures:
Outcomes were evaluated including stage at presentation, treatments given, sites of relapse, time to distant relapse, progression-free survival and overall survival (OS).
Results:
From a total 159 patients, 114 received first-line chemotherapy, 80.5% being platinum-based. Response rate was 48%. Commonest primary sites were genitourinary and gynaecological. 44% of patients presented with metastatic disease. 55.9% relapsed with liver the commonest site, whereas only 2.5% developed brain metastases. Median OS was 13.4 months for all patients, 7.6 months and 19.5 months for those with metastatic and non-metastatic disease, respectively. Gynaecological and head and neck patients had significantly better OS compared to gastrointestinal patients.
Conclusions:
EPSCCs demonstrate high response rates to chemotherapy and high rates of distant metastases. Primary sites may influence prognosis, and survival is optimal with a radical strategy. Brain metastases are rare and we therefore do not recommend prophylactic cranial irradiation.
