Association of Treatment Methods and Survival in Esophageal Neuroendocrine Carcinoma Population of Seer Database: A Retrospective Cohort Study

Background Esophageal neuroendocrine carcinoma (ENEC) is an uncommon and highly aggressive tumor with an obscure etiology. Thus, this study aimed to investigate the best treatment option for patients with ENEC. Methods This study identified patients with ENEC from the Surveillance, Epidemiology, and End Results (SEER) database between 1975 and 2021. Clinicopathological characteristics were analyzed using descriptive statistics, and prognostic factors were determined through Cox regression analysis. Kaplan–Meier survival analysis was used to assess five-year overall survival (OS). Patients were divided into a combined radiotherapy and chemotherapy group and a surgery group based on treatment modality. Propensity score matching (PSM) was performed to balance baseline characteristics between the two groups. Results A total of 604 participants were included in the study. Univariate and multivariate analyses showed that ENEC patients with localized or regional disease had significantly better survival rates than those with distant metastases (HR = 0.38, P < 0.001 and HR = 0.56, P < 0.001). Both radiotherapy and chemotherapy (HR = 0.34, P < 0.001) and surgery (HR = 0.43, P < 0.001) significantly improved survival. Kaplan–Meier analysis revealed significant differences in OS (P < 0.0001), with combination therapy and surgery groups having the highest survival rates (7.04% and 8.77%, respectively), with combination therapy maintaining the best survival rate over time. Conclusion The synergistic application of radiotherapy and chemotherapy has markedly enhanced the five-year survival rate of patients with ENEC, offering invaluable insights for clinical management strategies.