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Journal of Gastrointestinal Cancer

, Volume 50, Issue 2, pp 244–253 | Cite as

Evaluating Treatment Patterns for Small Cell Carcinoma of the Colon Using the National Cancer Database (NCDB)

  • Sadhana Balasubramanyam
  • Barrett P. O’Donnell
  • Benjamin L. Musher
  • Pavan M. Jhaveri
  • Michelle S. Ludwig
Original Research

Abstract

Objective(s)

The objective of this study was to characterize the clinicopathological prognostic factors and treatment patterns for small cell carcinoma (SCC) of the colon, a rare disease without standard treatment guidelines.

Methods

We analyzed clinicopathological and treatment variables for 503 cases of histologically proven SCC colon entered into the National Cancer Database (NCDB) between 2004 and 2013. Survival curves were generated using Kaplan-Meier and compared by the log-rank test. Cox proportional hazard regression was used to control for covariates and evaluate the effect of different treatment modalities on overall survival.

Results

Four hundred seventy-two (93.8%) patients had complete clinical staging information and were therefore included in our analysis. Of these patients, 149 (31.5%) had limited stage disease (LD) and 323 (68.4%) had extensive stage disease (ED) at presentation. Median overall survival (OS) for patients with ED was significantly lower than for those with LD (4.04 months vs. 21.82 months; p < 0.001). Multivariate Cox regression analysis showed administration of chemotherapy was associated with improved survival in patients with LD and ED (p = 0.026, p < 0.001) while surgery was not associated with improved survival in patients with LD or ED (p = 0.943, p = 0.630). Radiation therapy was associated with improved survival in patients with ED (p = 0.044).

Conclusions

SCC of the colon carries a poor prognosis, especially in patients presenting with metastatic disease. Surgery and chemotherapy are administered more frequently than radiation, and chemotherapy is associated with improved survival, unlike surgery.

Keywords

Extrapulmonary small cell carcinoma Colon cancer Radiation Chemotherapy 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

References

  1. 1.
    Liu Y, Sturgis CD, Grzybicki DM, Jasnosz KM, Olson PR, Tong M, et al. Microtubule-associated protein-2: a new sensitive and specific marker for pulmonary carcinoid tumor and small cell carcinoma. Mod Pathol. 2001;14(9):880–5.  https://doi.org/10.1038/modpathol.3880406.CrossRefPubMedGoogle Scholar
  2. 2.
    Brenner B, Shah MA, Gonen M, Klimstra DS, Shia J, Kelsen DP. Small-cell carcinoma of the gastrointestinal tract: a retrospective study of 64 cases. Br J Cancer. 2004;90(9):1720–6.  https://doi.org/10.1038/sj.bjc.6601758.CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Dores GM, et al. A population-based study of incidence and patient survival of small cell carcinoma in the United States 1992–2010. Arch Surg. 2015;15:185.  https://doi.org/10.1186/s12885-015-1188-y
  4. 4.
    Song Y, He J, Wu L, Wang L, Wang F. Treatment and prognosis of extrapulmonary small cell carcinoma of 243 cases. Chin J Oncol. 2010;32(2):132–8.Google Scholar
  5. 5.
    Remick SC, Hafez GR, Carbone P. Extrapulmonary small-cell carcinoma. A review of the literature with emphasis on therapy and outcome. Medicine. 1987;66(6):457–71.  https://doi.org/10.1097/00005792-198711000-00004.CrossRefPubMedGoogle Scholar
  6. 6.
    Dukes CE. The significance of the unusual in the pathology of intestinal tumors. Ann Roy Coll Surg Eng. 1949;4(2):90–103.PubMedGoogle Scholar
  7. 7.
    Clery AP, Dockerty MB, Waugh JM. Small cell carcinoma of the colon and rectum. A clinicopathologic study. Arch surg. 1961;83(2):164–72.  https://doi.org/10.1001/archsurg.1961.01300140006002.CrossRefPubMedGoogle Scholar
  8. 8.
    Galanis E, Frytak S, Lloyd RV. Extrapulmonary small cell carcinoma. Cancer. 1997;79(9):1729–36.CrossRefPubMedGoogle Scholar
  9. 9.
    Walenkamp AME, Sonke GS, Sleifer DT. Clinical and therapeutic aspects of extrapulmonary small cell carcinoma. Cancer Treat Rev. 2009;35(3):228–36.  https://doi.org/10.1016/j.ctrv.2008.10.007.CrossRefPubMedGoogle Scholar
  10. 10.
    Yaziji H, Broghamer WL. Primary small cell undifferentiated carcinoma of the rectum associated with ulcerative colitis. South Med J. 1996;89(9):921–4.  https://doi.org/10.1097/00007611-199609000-00016.CrossRefPubMedGoogle Scholar
  11. 11.
    Conte B et al (2016) High-grade neuroendocrine colorectal carcinomas: a retrospective study of 100 patients. Clinical Colorectal Cancer Volume pending.Google Scholar
  12. 12.
    Schneider EB, Hyder O, Brooke BS, et al. Patient readmission and mortality after colorectal surgery for colon cancer: impact of length of stay relative to other clinical factors. J Am Coll Surg. 2012;214(4):390–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Hochstenbag MM, et al. Asymptomatic brain metastases (BM) in small cell lung cancer (SCLC): MR-imaging is useful at initial diagnosis. J Neurooncol. 2000;48(3):243–8.  https://doi.org/10.1023/A:1006427407281.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Sadhana Balasubramanyam
    • 1
  • Barrett P. O’Donnell
    • 1
  • Benjamin L. Musher
    • 2
  • Pavan M. Jhaveri
    • 2
  • Michelle S. Ludwig
    • 2
    • 3
  1. 1.John P. and Katherine G. McGovern Medical SchoolHoustonUSA
  2. 2.Baylor College of MedicineHoustonUSA
  3. 3.HoustonUSA

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