Role of surgery in the management and prognosis of limited-stage small cell carcinoma of the esophagus.

Abstract

Small cell carcinoma of the esophagus (SCCE) is a rare, highly aggressive tumor characterized by early dissemination and a poor prognosis. Surgery, chemotherapy, and radiotherapy have been used alone or in combination for the treatment of this rare disease. The aim of this retrospective study was to analyze the role of surgery in the management of limited-stage SCCE at a high-volume center. We retrospectively evaluated 73 patients with limited-stage SCCE who received an esophagectomy at our center from January 1994 to December 2011. The clinical characteristics, median survival times (MSTs), overall survival (OS), and relevant prognostic factors were analyzed. The overall MST was 23.0 months, and the 1-, 2-, 3-, and 5-year OS rates were 61.6%, 47.9%, 22.7%, and 10.6%, respectively. The MST for patients without lymph node involvement (33.0 months) was greater than the MST for patients with lymph node involvement (17.0 months) (P = 0.014). Similarly, patients who underwent radical resection had a greater MST (25.0 months) than patients who underwent palliative resection (7.0 months) (P = 0.004). Patients who received chemotherapy had a greater MST (27.0 months) than patients who did not receive chemotherapy (13.0 months) (P = 0.021). Survival analysis confirmed that a radical operation, chemotherapy, and lymph node involvement were independent prognostic factors. This study suggests that radical resection combined with chemotherapy should be recommended for patients with limited-stage SCCE, especially patients with negative regional lymph nodes. A lack of lymph node metastasis was a good prognostic factor because patients without lymph node involvement had greater OS.

• Authors: M R Xie, S B Xu, X H Sun, L Ke, X Y Mei, C Q Liu, D C Ma
• Journal: Diseases of the esophagus : official journal of the International Society for Diseases of the Esophagus (Dis Esophagus) Vol. 28 Issue 5 Pg. 476-82 (Jul 2015) ISSN: 1442-2050 [Electronic] United States
• PMID: 24787553 (Publication Type: Journal Article)
• Copyright: © 2014 International Society for Diseases of the Esophagus.

Chemical References

• Antineoplastic Agents

Topics

• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Carcinoma, Small Cell (mortality, pathology, therapy)
• Combined Modality Therapy (methods, mortality)
• Esophageal Neoplasms (mortality, pathology, therapy)
• Esophagectomy (methods, mortality)
• Female
• Humans
• Lymph Nodes (pathology, surgery)
• Male
• Middle Aged
• Neoplasm Staging
• Prognosis
• Retrospective Studies
• Survival Analysis