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Clinicopathologic and immunohistochemical features of surgically resected small cell carcinoma of the esophagus.

Abstract
Esophageal small cell carcinoma (SmC) is considered an aggressive cancer carrying a poor prognosis, although the rarity of this tumor has impeded statistical evaluation. We reviewed records of 457 esophageal cancer patients treated in our department from 1986 to 2000, comparing clinicopathologic factors and post-treatment outcomes, for 9 patients with SmC, most undergoing esophagectomy including lymphadenectomy, with data from 128 patients with esophageal squamous cell carcinoma (SqC) invading to the muscular layer or beyond. Immunohistochemical features were compared between the SmC and 12 consecutive SqC. All patients studied had localized disease according to preoperative staging. SmC showed more ulcerative and infiltrative growth, and more aggressive lymphatic spread, than SqC. All SmC patients had lymph node metastasis (thoracic nodes, 9 patients: abdominal 6; cervical 1). All SmC specimens but no SqC were immunoreactive for neuron-specific enolase. Two and three SmC specimens were reactive for epithelial membrane antigen and keratin, respectively. Survival of SmC patients after esophagectomy (median, 11 months) was worse than for SqC patients (p=0.013). However, 1 SmC patient remains alive at 76 months. Survival was not related to any clinicopathologic or immunohistochemical features. While SmC shows aggressive behavior and worse outcomes than SqC, combining esophagectomy with chemotherapy or radiotherapy may prolong survival.
AuthorsHarushi Osugi, Masashi Takemura, Keiichirou Morimura, Masahiro Kaneko, Masayuki Higashino, Nobuyasu Takada, Sigeru Lee, Hiroaki Kinoshita
JournalOncology reports (Oncol Rep) 2002 Nov-Dec Vol. 9 Issue 6 Pg. 1245-9 ISSN: 1021-335X [Print] Greece
PMID12375028 (Publication Type: Comparative Study, Journal Article)
Topics
  • Aged
  • Carcinoma, Small Cell (pathology, surgery)
  • Carcinoma, Squamous Cell (pathology, surgery)
  • Case-Control Studies
  • Esophageal Neoplasms (pathology, surgery)
  • Esophagectomy
  • Esophagus (pathology)
  • Female
  • Humans
  • Immunoenzyme Techniques
  • Incidence
  • Lymph Node Excision
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Staging
  • Postoperative Complications
  • Prognosis

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