Open AccessMulticenter retrospective analysis of systemic chemotherapy for advanced neuroendocrine carcinoma of the digestive system
Author(s) -
Yamaguchi Tomohiro,
Machida Nozomu,
Morizane Chigusa,
Kasuga Akiyoshi,
Takahashi Hideaki,
Sudo Kentaro,
Nishina Tomohiro,
Tobimatsu Kazutoshi,
Ishido Kenji,
Furuse Junji,
Boku Narikazu,
Okusaka Takuji
Publication year - 2014
Publication title -
cancer science
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.035
H-Index - 141
eISSN - 1349-7006
pISSN - 1347-9032
DOI - 10.1111/cas.12473
Subject(s) - medicine , gastroenterology , chemotherapy , stomach , hazard ratio , cisplatin , confidence interval
This study analyzed outcomes of systemic chemotherapy for advanced neuroendocrine carcinoma ( NEC ) of the digestive system. Clinical data from 258 patients with unresectable or recurrent NEC of the gastrointestinal tract ( GI ) or hepato‐biliary‐pancreatic system ( HBP ), who received chemotherapy, were collected from 23 Japanese institutions and analyzed retrospectively. Patients had primary sites in the esophagus ( n = 85), stomach ( n = 70), small bowel ( n = 6), colorectum ( n = 31), hepato‐biliary system ( n = 31) and pancreas ( n = 31). Median overall survival ( OS ) was 13.4 months the esophagus, 13.3 months for the stomach, 29.7 months for the small bowel, 7.6 months for the colorectum, 7.9 months for the hepato‐biliary system and 8.5 months for the pancreas. Irinotecan plus cisplatin ( IP ) and etoposide plus cisplatin ( EP ) were most commonly selected for GI ‐ NEC and HBP ‐ NEC . For patients treated with IP / EP ( n = 160/46), the response rate was 50/28% and median OS was 13.0/7.3 months. Multivariate analysis among patients treated with IP or EP showed that the primary site ( GI vs HBP ; hazard ratio [ HR ] 0.58, 95% confidence interval [ CI ] 0.35–0.97) and baseline serum lactate dehydrogenase levels (not elevated vs elevated; HR 0.65, 95% CI 0.46–0.94) were independent prognostic factors for OS , while the efficacy of IP was slightly better than for EP ( HR 0.80, 95% CI 0.48–1.33; P = 0.389). IP and EP are the most common treatment regimens for NEC of the digestive system. HBP primary sites and elevated lactate dehydrogenase levels are unfavorable prognostic factors for survival. A randomized controlled trial is required to establish the appropriate chemotherapy regimen for advanced NEC of the digestive system. This study was registered at UMIN as trial number 5176.