Data from: Patterns of relapse in extrapulmonary small cell carcinoma: retrospective analysis of outcomes from two cancer centres

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.研究目的：本研究针对肺外小细胞癌（extrapulmonary small cell carcinomas, EPSCCs）患者开展回顾性分析，旨在按原发部位探究其疾病分布、治疗方案、复发模式及预后转归。 数据来源：本研究的患者队列来自两所大型癌症中心，为目前规模最大的连续入组EPSCC患者数据集之一，我们对该队列的预后数据进行了回顾性分析。 研究对象：本研究回顾性筛选了两所医疗机构内经组织病理学确诊为EPSCC的连续入组患者。 结局指标：本研究评估的主要及次要结局指标包括确诊时的临床分期、接受的治疗方案、复发部位、远处复发时间、无进展生存期及总生存期（overall survival, OS）。 研究结果：本队列共纳入159例患者，其中114例接受一线化疗，80.5%的患者采用铂类为基础的化疗方案；总体缓解率为48%。最常见的原发部位为泌尿生殖系统与妇科系统。44%的患者确诊时已出现远处转移。55.9%的患者发生复发，其中肝脏为最常见的复发部位，仅2.5%的患者出现脑转移。所有患者的中位总生存期为13.4个月，伴远处转移患者与无远处转移患者的中位总生存期分别为7.6个月与19.5个月。妇科系统及头颈部原发EPSCC患者的总生存期显著优于胃肠道原发患者。 研究结论：肺外小细胞癌对化疗具有较高的缓解率，但远处转移发生率较高。原发部位可影响患者预后，采用根治性治疗策略可获得最优生存结局。由于脑转移发生率极低，本研究不推荐常规实施预防性颅脑照射。