Clinical Features and Prognosis of Neuroendocrine Carcinoma of Esophagus: 41 Cases Analysis_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

GUXiang-sen ¹ ,  ZHOUYue ² , WANGWei ² , LUOJin-hua ² , CHENLiang ²

1. Department of Thoracic Surgery, The Affiliated Jiangdu People's Hospital, Yangzhou University, Yangzhou 225200 Jiangsu, P. R. China;
2. Department of Cardiothoracic Surgery, The First Affiliated Hospital, Nanjing Medical University, Nanjing 210029 Jiangsu, P. R. China;

Corresponding author：

ZHOUYue, Email: chirurgeonzhouyue@163.com

Keywords：

Esophageal carcinoma; Neuroendocrine carcinoma; Prognosis

DOI：

10.7507/1007-4848.20160234

Video：

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Objective To explore the clinical features and the prognostic factors of neuroendocrine carcinoma of the esophagus. Methods We retrospectively analyzed clinical data of 41 cases of neuroendocrine carcinoma of the esophagus admitted in the First Affiliated Hospital of Nanjing Medical University between March 2008 and March 2014. There were 37 males and 4 females at a mean age of 61.1±7.9 years (ranged from 40 to 79 years). All patients underwent surgical resection and lymph node dissection. Results No severe complications occurred during the perioperative period, and no death occurred during the period of hospitalization.Thirteen patients received postoperative chemotherapy and radiotherapy. Eleven patients received simple postoperative chemotherapy. One patient received postoperative radiotherapy. The remaining 16 patients did not receive any special treatment. The patients were followed up for 6 to 61 (24.0±13.6)months. Twenty-two patients survived, the other 19 patients died. The 1-year, 2-year, 3-year, 4-year, and 5-year survival rate was 80.49%, 39.02%, 21.95%, 7.32%, and 4.88%, respectively. The median survival of single surgical treatment and postoperative comprehensive treatment was 12.0 months and 25.0 months, respectively. The median survival of T₂-T₄ and T₁ was 20.0 months and 37.5 months, respectively. The difference was statistically different (P<0.05). Cox regression analysis showed that the depth of tumor invasion, postoperative adjuvant chemotherapy and radiotherapy were independent factors of prognosis (P<0.05). Conclusions Neuroendocrine carcinoma of the esophagus is rare and with a high degree of malignancy. It is expected to increase the long-term survival rate after surgical and postoperative comprehensive treatment.

Citation： GU Xiang-sen, ZHOU Yue, WANG Wei, LUO Jin-hua, CHEN Liang. Clinical Features and Prognosis of Neuroendocrine Carcinoma of Esophagus: 41 Cases Analysis. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(10): 978-981. doi: 10.7507/1007-4848.20160234 Copy

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1. Bosman FT, Carneiro F, Hruban RH, et al. WHO classification of tumours of the digestive system. 4th edition. Lyon: IARC Press. 2010.
2. 李增山, 李青. 2010年版消化系统肿瘤WHO分类解读. 中华病理学杂志, 2011, 40(5): 351-354.
3. Estrozi B, Bacchi CE. Neuroendocrine tumors involving the gastroenteropancreatic tract: a clinicopathological evaluation of 773 cases. Clinics (Sao Paulo), 2011, 66(10): 1671-1675.
4. Kuo CH, Hsieh CC, Chan ML, et al. Small cell carcinoma of the esophagus: a report of 16 cases from a single institution and literature review. Ann Thorac Surg, 2011, 91(2): 373-378.
5. Maru DM, Khurana H, Rashid A, et al. Retrospective study of clinicopathologic features and prognosis of high-grade neuroendocrine carcinoma of the esophagus. Am J Surg Pathol, 2008, 32(9): 1404-1411.
6. Frazier SR, Kaplan PA, Loy TS. The pathology of extrapulmonary small cell carcinoma. Semin Oncol, 2007, 34(1): 30-38.
7. Nekulova M, Holcakova J, Coates P, et al. The role of p63 in cancer, stem cells and cancer stem cells. Cell Mol Biol Lett, 2011, 16(2): 296-327.
8. Huang Q, Wu H, Nie L, et al. Primary high-grade neuroendocrine carcinoma of the esophagus: a clinicopathologic and immunohistochemical study of 42 resection cases. Am J Surg Pathol, 2013, 37(4): 467-483.
9. Li AF, Li Ac, Hsu CY, et al. Small cell carcinomas in gastrointestinal tract: immunohistochemical and clinicopathological features. J Clin Patllol, 2010, 63(7): 620-625.
10. Lu J, Xue LY, Lu N, et al. Superficial primary small cell carcinoma of the esophagus: clinic pathological and immunohistochemical analysis of 15 cases. Dis esophagus, 2010, 23(2): 153-159.
11. 周海榆, 陈刚, 林华欢, 等.原发性食管神经内分泌癌影像学及病理特征. 广州医学院学报, 2011, 39(1): 24-28.
12. Lu XJ, Luo JD, Ling Y, et al. Management of small cell carcinoma of esophagus in china. J Gastrointest Surg, 2013, 17(7): 1181-1187.
13. 邵明雯, 孙婧, 马兰, 等. 具有神经内分泌性质食管癌的临床病理特点及生存分析. 中华肿瘤防治杂志, 2014, 21(24): 1980-1985.
14. 邵令方, 王其彰, 主编. 新编食管外科学. 石家庄: 河北科学技术出版社, 2006. 568-569.
15. 隋燕霞, 张勇, 党诚学, 等. 食管原发性神经内分泌癌33例临床病理分析. 胃肠病学, 2014, 19(3): 139-142.
16. 袁柏思, 金鑫鑫, 刘炯, 等. 食管神经内分泌癌: 临床病例回顾性分析. 诊断病理学杂志, 2015, 22(12): 740-743.
17. 高静, 徐鲁白, 王继生, 等. 食管神经内分泌癌七例并文献复习. 肿瘤研究与临床, 2015, 27(8): 561-564.
18. Ding J, Ji J, Zhu W, et al. A retrospective study of different treatments of limited-stage small-cell esophageal carcinoma and associated prognostic factor analysis. Dis Esophagus, 2013, 26 (7): 696-702.
19. Chen SB, Yang JS, Yang WP, et al. Treatmentand prognosis of limited disease primary small cell carcinoma of esophagus. Dis Esophagus, 2011, 24(2): 114-119.
20. 焦文鹏, 曹峰, 王军. 食管小细胞癌研究现状. 中华肿瘤防治杂志, 2015, 22(4): 315-319.
21. Strosberg JR, Coppola D, Klimstra DS, et al. The NANETS consensus guidelines for the diagnosis and management of poorly differentiated (high-grade) extrapulmonary neuroendocrine carcinomas. Pancreas, 2010, 39(6): 799-800.
22. Eriksson B, Annibale B, Bajetta E, et al. ENETS Consensus Guidelines for the Standards of Care in Neuroendocrine Tumors: chemotherapy in patients with neuroendocrine tumors. Neuroendocrinology, 2009, 90(2): 214-219.
23. National Comprehensive Cancer Network (NCCN). NCCN Clinical Practice Guidelines in Oncology. Vol 10. Fort Washington: National Comprehensive Cancer Network. 2010.
24. Lu ZH, Li J, Lu M, et al. Feasibility and efficacy of combined cisplatin plus irinotecan chemotherapy for gastroenteropancreatic neuroendocrine carcinomas. Med Oncol, 2013, 30(3): 664.
25. 梁后杰, 杨晨. 胃肠胰腺神经内分泌肿瘤治疗共识(NCCN、ENETs、NANETs)解读. 临床肿瘤学杂志, 2011, 16(11): 1039-1043.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinical Features and Prognosis of Neuroendocrine Carcinoma of Esophagus: 41 Cases Analysis

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