Analysis Of Clinical Factors Of Small Cell Carcinoma In Different Primary Sites

Part I: Clinical features and prognosis of small cell carcinoma in different primary sites?Objective?The clinical characteristics of small cell carcinoma in different primary sites were compared and analyzed to identify the prognostic factors.?Method?Clinical data were collected in the SEER database for patients who met the inclusion criteria.The tumor was grouped according to the primary tumor site,and Fisher's exact probability method was used to compare the variables between the groups.K-m(kaplan-meier)plotted the survival curves of each group.Log-rank test was performed for single-factor correlation analysis,and then verified by Cox risk regression model to further clarify the risk factors affecting prognosis.In this article,SPSS25.0 statistical software was used for statistical analysis,and P< 0.05 indicated statistical significance.?Result?A total of 59,028 patients meeting the enrollment criteria were screened from the SEER database and divided into six groups according to the primary site.Among them,57395 cases of small cell lung cancer(SCLC).There were 643 small cell carcinoma of the bladder(SCCB),320 cases of small cell carcinoma of cervix(SCCC),295 cases of small cell prostate cancer(SCPC),and There were 196 cases of small cell esophageal carcinoma(SCEC)and 179 cases of small cell carcinoma of the pancreas(SCCP).Among the clinical features,In terms of age,SCCC accounts for 30.9% in the36-50 age group.The other five groups had the highest incidence at ?66 years.As forrace,the six groups had higher rates among whites.Regarding gender,SCCB and SCEC accounted for 74.2% and 64.3% of men,while women accounted for 25.8% and35.7%.Regarding the degree of differentiation,all six groups had a small number of highly differentiated people.Among the stages,all groups had the highest proportion of small cell carcinomas in stage IV.In the Summary stage,the limited proportion of SCCB was 46.8%,and small cell carcinomas in other parts were more prone to distant metastasis.About the treatment,the six groups were more likely to receive chemotherapy.In terms of surgery,the proportion of SCCB was 90.4%,and the proportion of the remaining five groups was even lower.In terms of radiotherapy,SCCC accounted for 62.2% of the radiotherapy,and the other groups received fewer radiotherapy.In K-M analysis,in terms of overall survival(OS),the median survival times of SCCC,SCCB,SCCP,and SCLC were 17.0,10.0,4.0,and 7.0 months,respectively.Regarding cancer specific survival(CSS),the median survival times of SCCP,SCLC,SCCB,and SCCC were 4.0,7.0,12.0,and 18 months,respectively.All the above have significant statistical differences(P <0.001).In SCCB,the gaps between CSS and OS are 5.9%,6.0%,and 5.2%,respectively.In terms of prognostic analysis,regarding SCLC,age,gender,ethnicity,stage,degree of differentiation,and treatment were independent prognostic factors affecting OS and CSS(P <0.05).For SCCB,surgery and chemotherapy were prognostic factors associated with OS(P <0.05).In SCCC,age,chemotherapy and surgery are prognostic factors affecting OS(P <0.05).Age and chemotherapy are factors that influence the prognosis of CSS(P<0.05).In SCPC,differentiation and chemotherapy were independent prognostic factors related to OS(P < 0.05).The degree of differentiation was an independent prognostic factor for CSS(P < 0.05).For SCCE,chemotherapy was an independent prognostic factor(P < 0.05).Surgery and chemotherapy were associated prognostic factors in SCCP(P < 0.05).?Conclusion?1.Small-cell carcinoma occupies the highest proportion in the lungs,and themajority outside the lungs occur in the urinary tract,gastrointestinal tract and female reproductive system.2.The clinical characteristics of small-cell carcinomas in different primary sites are different.3.The survival of SCCC and SCCB is better than that of SCLC and SCCP.The difference between OS and CSS is most obvious in SCCB.4.Small cell carcinomas in different tissue sites have different prognostic factors.Part II: Metastatic patterns of small cell carcinomas in different primary sites?Objective?The metastatic patterns of small cell carcinoma in different primary sites were compared and analyzed.?Method?Screen the relevant information of small cell carcinoma patients with SEER database that met the inclusion criteria from 2010 to 2015.To compare the correlation between single and multiple metastasis patterns of lung,brain,liver and bone metastases in different small cell carcinomas.The kaplan-meier method was used to plot the survival curves of different single-pass sites,and the log-rank sum test was used for comparison.?Result?We collected data from 26,499 patients.There were 25714,374,166,165,84 and80 small cell carcinomas of the lung,bladder,cervix,prostate,pancreas and esophagus.In single metastases,liver,lung,brain,and bone metastases accounted for 40.3%,13.4%,24.5%,and 21.7% of small cell carcinoma.The proportions of liver metastases in SCCP,SCEC,SCLC,and SCCB were 56.1%,73.7%,40.1%,and 56.1%,respectively.Only 71.7% of bone metastases occurred in SCPC.The rate of bone metastasis and liver metastasis in SCCC was 32.1%.For multiple metastases,there are 11 combinations.The proportion of bone metastasis + liver metastasis was 34.3%,and the proportion of bone metastasis + lung metastasis + brain metastasis was only 1.8%.The proportions of bone metastases and liver metastases in SCEC,SCPC,SCLC and SCCB were 53.3%,32.6%,34.3% and37.8% respectively.The proportion of lung metastasis + liver metastasis and liver metastasis + bone metastasis in SCCC was 28.6%.In SCCP,the proportion of liver +lung metastasis was 41.2%.In K-M analysis,the median survival time of small cell carcinoma in liver metastasis was 3.0 and 4.0 months in terms of OS and CSS,respectively.Similarly,median survival times for lung,bone,and brain metastases were 6.0,7.0,6.0 months and 7.0,8.0,6.0 months,respectively.The difference was statistically significant(P<0.001).?Conclusion?1.Among the single metastases,small cell carcinoma is the most prone to liver metastases,followed by brain,bone and lung metastasis.2.SCCP,SCEC,SCLC and SCCB are the most prone to liver metastasis,and SCPC is the most prone to bone metastasis.3.Among multiple metastases,the most patients with liver metastases + bone metastases.4.Small cell carcinoma with liver metastasis has the worst survival.