Clinicopathological Features and Outcomes of Multidisciplinary Therapy of Primary Esophageal Small-cell Carcinoma_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

MIAO Zhenjun , GAO Qiang , LIN Yidan , CHEN Longqi.

1.Department of Thoracic Surgery, West China Hospital, Sichuan University, Chengdu 610041, P.R.China;;
2. West China School of Medicine, Sichuan　University, Chengdu 610041, P. R. China;

Corresponding author：

Keywords：

Primary esophageal small-cell carcinoma; ?Multidisciplinary therapy; ?Survival rate

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Abstract：　Objective　To investigate prognosis factors of primary small cell carcinoma of the esophagus （PSCCE）, and to optimize the treatment strategy of PSCCE.　Method　We retrospectively analyzed clinical data of 15 patients （13 males and 2 females with an age of 57.7±2.3 years） with middle thoracic　PSCCE in West China Hospital from June 2005 to February 2010. We searched ISI and MEDLINE from April 2001 to February 2010 to extract clinical data of 139 PSCCE patients with 94 males and 45 females with an age of 63.3±10.7 years. We analyzed prognosis factors of the 139 patients including gender, age, tumor location, pathological type, lesions stage and treatment strategy by Kaplan-Meier. Difference in survival curves between limited disease patients and extended disease patients was tested by log-rank test.　Results　Among the 15 patients, 14 patients had limited disease, and 1 patient had extended disease. Their data were not included in survival analysis because the follow-up was incomplete. Among the 139 patients, 88 patients had limited disease with their 2-year survival rate of 31.8% （28/88）. Fifty-one patients had extended disease with their 2-year survival rate of 7.8% （4/51）. The 2-year survival rate between limited-disease patients and extended-disease patients was statistically different（P＜0.05）. Radiation therapy in combination with chemotherapy had significant influence on the survival rate of patients with either local lesions or advanced lesions（P＜ 0.05）, while other factors such as gender, age and tumor location had no　significant influence on their survival rate（P＞0.05）.　Conclusion　Chemotherapy is the fundamental treatment of PSCCE, which plays an important role in reducing PSCCE preoperative staging and restraining PSCCE postoperative recurrence and metastasis. Surgery and radiation therapy are effective for patients with local lesions. Local treatment in combination with chemotherapy is effective for patients with limited disease. Radiation therapy in combination with chemotherapy is the standard therapy for patients with extended lesions,

Citation： MIAO Zhenjun,GAO Qiang,LIN Yidan,CHEN Longqi.. Clinicopathological Features and Outcomes of Multidisciplinary Therapy of Primary Esophageal Small-cell Carcinoma. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2012, 19(4): 390-394. doi: Copy

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1. experience and literature review. Cancer，2000，88 （2）：262-267．.
2. 　Wong YN， Jack RH， Mak V， et al. The epidemiology and survival of extrapulmonary small cell carcinoma in South East England， 1970-2004. BMC Cancer， 2009， 9：209.
3. 　Brega MP， Conti B， Lequaglie C， et al. The role of surgical therapy for esophageal microcytoma. Experience of there clinical cases and results analysis. Minerva Chir， 2003， 58 （4）：629-632.?.
4. 　Thomas WR， Blackstone EH， Valerie WR. A cancer staging primer：Esophagus and esophagogastric junction. J Thorac Cardiovasc Surg， 2010， 139 （3）：527-529.
5. 　Hosokawa A， Shimada Y， Matsumura Y， et al. Small cell carcinoma of the esophagus. Analysis of 14 cases and literature　review.Hepatogastroenterology， 2005， 52 （66）：1738-1741.
6. 　Horai T， Kobayashi A， Tateishi R， et al. A cytologic study of small　cell carcinoma of the esophagus. Cancer， 1978， 41 （5）：1890-1896.
7. 　伍伫，杨俊杰，张尚福. 原发性食管小细胞癌. 中国胸心血管外科临床杂志， 2002， 9 （2）：96-98．.
8. 　Zelen M. Keynote address on biostatistics and data retrieval. Cancer Chemother Rep， 1973， 4 （12）：31-42.
9. 　Huncharek M， Muscat J. Small-cell carcinoma of the esophagus-the Massachusetts-General-Hospital experience， 1978 to 1993. Chest， 1995， 107 （1）：179-181.
10. 　Medgyesy DC， Wolff RA， Putnam JB Jr， et al．Small cell carcinoma of the esophagus-The University of Texas M. D. Anderson Cancer Center.
11. 　Yun JP， Zhang MF， Hou JH， et al. Primary small cell carcinoma of the esophagus：clinicopathological and immunohistochemical features of 21 cases. BMC Cancer， 2007 （7）：38.
12. 　卢绪菁，孔颖泽，王建华. 原发性食管小细胞癌的研究进展. 世界华人消化杂志， 2009， 17 （34）：3519-3523．.
13. 　Yau KK， Siu WT， Wong D， et al. Non-operative management of small cell carcinoma of esophagus. Diseases of the Esophagus， 2007， 20 （6）：487-490.
14. 　Arquette M， Wasserman T， Govindan R， et al. Phase II evaluation of amifostine as an esophageal mucosal protectant in the treatment of limited-stage small cell lung cancer with chemotherapy and twice-daily radiation. Semin Radiat Oncol， 2002， 12 （1）：59-61.
15. 　Yamashita H， Nakagawa K， Asari T， et al. Concurrent chemoradiation alone with curative intent for limited-disease small-cell esophageal cancer in nine Japanese patients. Diseases of the Esophagus， 2009， 22 （2）：113-118.
16. 　Nichols GL， Kelsen DP. Small cell carcinoma of the esophagus. The Memorial Hospital experience 1970 to 1987. Cancer， 1989， 64：1531-1533.
17. 　Hudson E， Powell J， Mukherjee S， et al. Small cell oesophageal carcinoma：an institutional experience and review of the literature. Br J Cancer， 2007， 96 （10）：708-711.
18. 　Mitani M， Kuwabara Y， Shinoda N， et al. Long-term survivors after the resection of limited esophageal small cell carcinoma. Diseases of the　Esophagus， 2000， 13 （3）：259-261.
19. 　陈耀辉，张大为，董国俊，等. 原发性食管小细胞未分化癌. 中华肿瘤杂志， 1991， 13 （5）：366-368．.
20. 　Francesc C， Ferran F， Blanca F， et al. Primary small cell carcinoma of the esophagus. A review of the literature with emphasis on therapy and prognosis. Cancer， 1997， 80 （8）：1366-1372.
21. 　周谦君，杨明训，彭寿行，等. 原发性食管小细胞癌二例. 中国胸心血管外科临床杂志， 2001， 8 （3）：146．.

Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Clinicopathological Features and Outcomes of Multidisciplinary Therapy of Primary Esophageal Small-cell Carcinoma

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