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Article ; Online: Evaluating Treatment Patterns for Small Cell Carcinoma of the Colon Using the National Cancer Database (NCDB).

Balasubramanyam, Sadhana / O'Donnell, Barrett P / Musher, Benjamin L / Jhaveri, Pavan M / Ludwig, Michelle S

Journal of gastrointestinal cancer

2018  Volume 50, Issue 2, Page(s) 244–253

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 ... ...

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.
MeSH term(s) Adult ; Aged ; Aged, 80 and over ; Carcinoma, Small Cell/mortality ; Carcinoma, Small Cell/pathology ; Carcinoma, Small Cell/therapy ; Colonic Neoplasms/mortality ; Colonic Neoplasms/pathology ; Colonic Neoplasms/therapy ; Combined Modality Therapy ; Databases, Factual ; Drug Therapy/statistics & numerical data ; Female ; General Surgery/statistics & numerical data ; Humans ; Male ; Middle Aged ; Neoplasm Staging ; Prognosis ; Radiotherapy/statistics & numerical data ; Survival Rate ; United States ; Young Adult
Language English
Publishing date 2018-01-31
Publishing country United States
Document type Journal Article
ZDB-ID 2452514-5
ISSN 1941-6636 ; 1559-0739 ; 1941-6628 ; 1537-3649
ISSN (online) 1941-6636 ; 1559-0739
ISSN 1941-6628 ; 1537-3649
DOI 10.1007/s12029-018-0054-y
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