Abstract：Objective To investigate the treatment modalities and prognostic factors for primary limited-stage small-cell esophageal cancer. Methods A retrospective analysis was performed in 121 patients with limited-stage small-cell esophageal cancer. In 98 patients undergoing surgery,37 received surgery alone,40 received surgery plus chemotherapy,and 21 received surgery plus chemoradiotherapy. In 23 patients receiving nonsurgical treatment,18 received chemoradiotherapy and 5 received chemotherapy alone. Survival rate was caculated with Kaplan-Meier method and log-rank test. Multivariate analysis of prognostic factors in Cox model. Results There were no significant differences in 1-,3-year overall survival (OS) rates between the surgery group and the non-surgery group (88% vs. 78%,37% vs. 43%;P=0.585).In the surgery group,there was no significant difference in LC rate between patients undergoing different treatment modalities (P=0.113);the surgery plus chemotherapy group and the surgery plus chemoradiotherapy group had significantly higher OS rates than the surgery alone group (P=0.002,P=0.028);there were no significant differences in the 1-,3-year OS rates between the surgery plus chemotherapy group and the surgery plus chemoradiotherapy group (88% vs. 83%,44% vs. 50%;P=0.969).Patients undergoing ≥4 cycles of chemotherapy had significantly higher 1-,3-year OS rates than those undergoing<4 cycles of chemotherapy (89% vs. 85%,53% vs. 35%;P=0.036).The multivariate analysis showed that chemotherapy was an independent factor for survival in patients with limited-stage small-cell esophageal cancer (P=0.006). Conclusions Patients undergoing surgery alone for limited-stage small-cell esophageal cancer have a poor prognosis. Compared with radiotherapy,surgery combined with systemic chemotherapy is not able to substantially improve local control and prognosis. Chemotherapy is an independent factor for survival in patients with limited-stage small-cell esophageal cancer. At least 4 cycles of chemotherapy are recommended.
Wang Jun,Jiao Wenpeng,Cao Feng et al. Treatment modalities for limited-stage small-cell esophageal cancer:an analysis of 121 patients [J]. Chinese Journal of Radiation Oncology, 2016, 25(7): 699-702.
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