Role of surgery in the management and prognosis of limited-stage small cell carcinoma of the esophagus
- 2 May 2014
- journal article
- Published by Oxford University Press (OUP) in Diseases of the Esophagus
- Vol. 28 (5), 476-482
- https://doi.org/10.1111/dote.12230
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.Keywords
This publication has 29 references indexed in Scilit:
- Oesophageal carcinomaThe Lancet, 2013
- Primary small cell carcinoma of the pancreas: rare type of pancreatic cancer and review of the literaturesWorld Journal of Surgical Oncology, 2012
- Small cell carcinoma of the esophagus: a multicentre Rare Cancer Network studyDiseases of the Esophagus, 2010
- Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008International Journal of Cancer, 2010
- Primary Small Cell Carcinoma of the EsophagusJournal of Thoracic Oncology, 2008
- Continuing Rapid Increase in Esophageal Adenocarcinoma in England and WalesThe American Journal of Gastroenterology, 2008
- Small cell oesophageal carcinoma: an institutional experience and review of the literatureBritish Journal of Cancer, 2007
- The Role of Overdiagnosis and Reclassification in the Marked Increase of Esophageal Adenocarcinoma IncidenceJNCI Journal of the National Cancer Institute, 2005
- Esophageal CancerThe New England Journal of Medicine, 2003
- Oat‐cell carcinoma of the œsophagusThe Journal of Pathology and Bacteriology, 1952