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.
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.
[1]焦文鹏,王军,刘青,等.局限期食管小细胞癌的淋巴结转移规律及影响因素[J].中华肿瘤杂志,2015,37(12):899-903.DOI:10.3760/cma.j.issn.0253-3766.2015.12.004 Jiao WP,Wang J,Liu Q,et al. Lymph node metastasis and its influencing factors in patients with small cell carcinoma of the esophagus[J].Chin J Oncol,2015,37(12):899-903.DOI:10.3760/cma.j.issn.0253-3766.2015.12.004 [2]Brega-Massone PP,Conti B,Lequaglie C,et al. The role of surgical therapy for esophageal microcytoma. Experience of there clinical cases and results analysis[J].Minerva Chir,2003,58(4):629-632 [3]焦文鹏,曹峰,王军.食管小细胞癌研究现状[J].中华肿瘤防治杂志,2015,22(4):315-319 Jiao WP,Cao F,Wang J.Current research of primary esophageal small cell of carcinomas[J].Chin J Cancer Prev Treat,2015,22(4):315-319 [4]Isolauri J,Mattila J,Kallioniemi OP.Primary undifferentiated small cell carcinoma of the esophagus:clinicopathological and flow cytometric evaluation of eight cases[J].J Surg Oncol,1991,46(3):174-177.DOI:10.1002/jso.2930460310 [5]Nakagawa S,Kanda T,Kosugi SI,et al. Recurrence pattern of squamous cell carcinoma of the thoracic esophagus after extended radical esophagectomy with three-field lymphadenectomy[J].J Am Coll Surg,2004,198(2):205-211.DOI:10.1016/j.jamcollsurg.2003.10.005 [6]Kyriazanos ID,Tachibana M,Shibakita M,et al. Pattern of recurrence after extended esophagectomy for squamous cell carcinoma of the esophagus[J].Hepatogastroenterology,2003,50(49):115-120 [7]Bhansali MS,Fujita H,Kakegawa T,et al. Pattern of recurrence after extended radical esophagectomy with three-field lymph node dissection for squamous cell carcinoma in the thoracic esophagus[J].World J Surg,1997,21(3):275-281.DOI:10.1007/s002689900228 [8]Aupérin A,Arriagada R,Pignon JP,et al. Prophylactic cranial irradiation for patients with small-cell lung cancer in complete remission. Prophylactic Cranial Irradiation Overview Collaborative Group[J].N Engl J Med,1999,341(7):476-484.DOI:10.1056/NEJM199908123410703 [9]Okudela K,Ito T,Kameda Y,et al. Immunohistochemical analysis for cell proliferation-related protein expression in small cell carcinoma of the esophagus;a comparative study with small cell carcinoma of the lung and squamous cell carcinoma of the esophagus[J].Histol Histopathol,1999,14(2):479-485 [10]Hosokawa A,Shimada Y,Matsumura Y,et al. Small cell carcinoma of the esophagus. Analysis of 14 cases and literature review[J].Hepatogastroenterology,2005,52(66):1738-1741 [11]宋岩,王绿化,赫捷,等.151例食管小细胞癌的治疗与预后分析[J].癌症,2009,28(3):303-307.DOI:10.3321/j.issn:1000-467X.2009.03.014 Song Y,Wang LH,Hao J,et al. Treatment and prognosis of primary esophageal small cell carcinoma:a report of 151 cases[J].Chin J Cancer,2009,28(3):303-307.DOI:10.3321/j.issn:1000-467X.2009.03.014 [12]Zhu Y,Qiu B,Liu H,et al. Primary small cell carcinoma of the esophagus:review of 64 cases from a single institution[J].Dis Esophagus,2014,27(2):152-158.DOI:10.1111/dote.12069 [13]张百华,杨文静,赵亮,等.109例原发性食管小细胞癌的外科治疗和预后分析[J].中华肿瘤杂志,2012,34(9):698-702.DOI:10.3760/cma.j.issn.0253-3766.2012.09.012 Zhang BH,Yang WJ,Zhao L,et al. Surgical treatment and prognostic analysis of 109 patients with primary esophageal small cell carcinoma[J].Chin J Oncol,2012,34(9):698-702.DOI:10.3760/cma.j.issn.0253-3766.2012.09.012 [14]李辉,刘曙光,刘希斌,等.原发性食管小细胞癌47例预后分析[J].肿瘤,2009,29(2):180-183.DOI:10.3781/j.issn.1000-7431.2009.02.018 Li H,Liu SG,Liu XB,et al. Prognostic analysis of forty seven patients with primary esophageal small cell carcinoma[J].Tumor,2009,29(2):180-183.DOI:10.3781/j.issn.1000-7431.2009.02.018 [15]王准,封巍,郑晓,等.食管小细胞癌的临床分析[J].中国癌症杂志,2006,16(6):508-510.DOI:10.3969/j.issn.1007-3639.2006.06.022 Wang Z,Feng W,Zheng X,et al. A clinical study in undifferentiated small cell carcinoma of the esophagus[J].China Oncol,2006,16(6):508-510.DOI:10.3969/j.issn.1007-3639.2006.06.022 [16]Meng MB,Zaorsky NG,Jiang C,et al. Radiotherapy and chemotherapy are associated with improved outcomes over surgery and chemotherapy in the management of limited-stage small cell esophageal carcinoma[J].Radiother Oncol,2013,106(3):317-322.DOI:10.1016/j.radonc.2013.01.008 [17]潘东风,顾兵,周方正,等.58例局限期食管小细胞癌治疗分析[J].肿瘤防治研究,2013,40(12):1183-1186.DOI:10.3971/j.issn.1000-8578.2013.12.017 Pan DF,Gu B,Zhou FZ,et al. Clinic therapy to primary esophageal small cell carcinoma with limited disease[J].Cancer Res Prev Treat,2013,40(12):1183-1186.DOI:10.3971/j.issn.1000-8578.2013.12.017 [18]王伟,黄志宇,陈明强,等.53例局限期原发食管小细胞癌治疗与预后分析[J].肿瘤学杂志,2013,19(5):342-345 Wang W,Huang ZY,Chen MQ,et al. Treatment and prognosis of 53 cases with localised primary esophageal small cell carcinoma[J].J Chin Oncol,2013,19(5):342-345.
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