ArticleThe oncologist2026
Treatment strategies for small cell carcinoma of the esophagus: comparative analysis of multimodal regimens in two independent real-world cohorts.
Article in The oncologist, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundSmall cell carcinoma of the esophagus (SCCE) is a rare and aggressive malignancy lacking a standardized treatment approach. Multimodal strategies such as chemotherapy plus surgery (CT + S) or chemotherapy plus radiotherapy (CT + RT) are commonly employed, but comparative evidence remains limited and inconsistent.
methodsWe retrospectively analyzed 491 patients with pathologically confirmed SCCE from 2 independent cohorts: a Chinese single-center cohort (n = 333) and the U.S. SEER database (n = 158). Patients who received monotherapy or multimodal treatment (CT + S or CT + RT) were eligible. Overall survival (OS) was evaluated using Kaplan-Meier analysis and Cox proportional hazards models. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) were applied to adjust for baseline confounders. Subgroup analyses explored potential effect modifiers.
resultsMultimodal therapy was associated with significantly improved OS compared to monotherapy in both cohorts (China: HR = 0.719, 95% CI: 0.561-0.922, P = .009; SEER: HR = 0.626, 95% CI: 0.417-0.938, P = .023). Among patients receiving multimodal therapy, no significant OS difference was observed between CT + S and CT + RT (P > .05), both before and after adjustment by PSM and IPTW. Subgroup analyses revealed no significant interactions between treatment strategy and clinical variables such as age, sex, tumor location, or disease stage.
conclusionsMultimodal therapy improves survival over monotherapy in SCCE. CT + S and CT + RT offer comparable effectiveness, supporting their clinical interchangeability and broader use in individualized treatment planning.
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