{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T00:52:17Z","timestamp":1787014337482,"version":"build-2736575974"},"reference-count":35,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2022,8,31]],"date-time":"2022-08-31T00:00:00Z","timestamp":1661904000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Internal Medicine Journal"],"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Extrapulmonary small cell cancer (EPSCC) is a rare malignancy with an incidence of approximately 0.1%\u20130.4% of all cancers. Treatment of this disease is often based on small cell lung cancer.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>We aimed to investigate real\u2010world clinical outcomes of patients with extensive\u2010stage (ES) ESPCC.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Patients diagnosed with ES EPSCC between 2010 and 2020 from multiple centres in New South Wales were identified. Patient, disease and treatment characteristics were collected and presented using descriptive statistics. Survival was analysed using the Kaplan\u2013Meier method. Univariate and multivariate Cox regression hazard models were used to identify potential prognostic factors.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Sixty eligible ES EPSCC patients were identified, including 65% male and 35% female. The mean age was 69\u2009years (range 37\u201388). Forty\u2010five per cent were never smokers, 42% ex\u2010smokers and 13% current smokers, and 17% of patients had limited\u2010stage disease prior to development of ES disease. The most common primary sites were genitourinary (42%; mainly prostate (\n                      <jats:italic>n<\/jats:italic>\n                      =\u200914) and bladder (\n                      <jats:italic>n<\/jats:italic>\n                      =\u200910)), gastrointestinal (28%; mainly oesophagus (\n                      <jats:italic>n<\/jats:italic>\n                      =\u20095) and colon (\n                      <jats:italic>n<\/jats:italic>\n                      =\u20094)) and unknown primary (22%). Treatments received included palliative chemotherapy (67%), palliative radiotherapy (53%), palliative surgery (13%) and best supportive care alone (13%). The median overall survival (OS) was 8.0 months. The median progression\u2010free survival was 5.4 months, and response rate to first\u2010line chemotherapy was 65%. Platinum\u2010based chemotherapy was prognostic of longer OS (HR 0.27, CI 0.12\u20130.60,\n                      <jats:italic>P<\/jats:italic>\n                      =\u20090.001).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Patients with ES EPSCC had good response to palliative chemotherapy, but OS remained poor. Further research is required to improve the prognosis in this population.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/imj.15907","type":"journal-article","created":{"date-parts":[[2022,8,16]],"date-time":"2022-08-16T03:54:59Z","timestamp":1660622099000},"page":"1556-1563","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Outcomes of extensive stage extrapulmonary small cell cancer"],"prefix":"10.1111","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1143-400X","authenticated-orcid":false,"given":"Geovanny","family":"Gandy","sequence":"first","affiliation":[{"name":"Liverpool Hospital  Sydney New South Wales Australia"},{"name":"Western Sydney University  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Po Yee","family":"Yip","sequence":"additional","affiliation":[{"name":"Western Sydney University  Sydney New South Wales Australia"},{"name":"Macarthur Cancer Therapy Centre, Campbelltown Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Annette","family":"Tognela","sequence":"additional","affiliation":[{"name":"Western Sydney University  Sydney New South Wales Australia"},{"name":"Macarthur Cancer Therapy Centre, Campbelltown Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Faisal","family":"Hayat","sequence":"additional","affiliation":[{"name":"Mid North Coast Cancer Institute, Coffs Harbour Hospital  Coffs Harbour New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Fox","sequence":"additional","affiliation":[{"name":"Mid North Coast Cancer Institute, Coffs Harbour Hospital  Coffs Harbour New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peey Sei","family":"Kok","sequence":"additional","affiliation":[{"name":"Western Sydney University  Sydney New South Wales Australia"},{"name":"National Health and Medical Research Council Clinical Trials Centre The University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,31]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005792-198711000-00004"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/mpo.2950200202"},{"key":"e_1_2_6_4_1","volume-title":"The Pathology of Extrapulmonary Small Cell Carcinoma. 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