Pantvaidya Gouri H, Pramesh C S, Deshpande Mandar S, Jambhekar Nirmala A, Sharma Sanjay, Deshpande Ramakant K
Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India.
Ann Thorac Surg. 2002 Dec;74(6):1924-7. doi: 10.1016/s0003-4975(02)04061-4.
Small cell carcinoma of the esophagus is a rare disease, characterized by aggressive progression. It has a high incidence of metastatic disease at presentation and a poor overall prognosis. Treatment protocols are not well established because of the paucity of cases and a lack of large studies.
We performed a retrospective review of all patients with small cell carcinoma of the esophagus diagnosed at the Tata Memorial Hospital between 1985 and 2001. We retrieved and analyzed data regarding demographic details, diagnosis, staging, type of treatment, and overall survival.
Eighteen patients with a mean age of 62 years (range 48 to 80 years) diagnosed as having small cell carcinoma of the esophagus were analyzed. The group included 13 men and 5 women. Seven of the 18 patients (39%) presented with metastatic disease including 5 patients (28%) with liver metastases. Four patients were treated with surgery, with or without chemotherapy or radiotherapy. Three patients were treated with combination chemoradiotherapy, 2 patients with chemotherapy alone, and 5 patients with radiotherapy alone. Four patients with advanced disease and poor general condition were not offered any treatment. The overall median survival of our patients was 6 months. Patients treated with surgery and chemotherapy had a better overall survival.
Small cell carcinoma of the esophagus should be regarded as a systemic disease with a high distant failure rate. Treatment strategies hence must incorporate systemic chemotherapy along with radical surgery or radiotherapy as part of a multimodality approach.
食管小细胞癌是一种罕见疾病，具有侵袭性进展的特点。其在发病时转移性疾病的发生率较高，总体预后较差。由于病例稀少且缺乏大型研究，治疗方案尚未明确确立。
我们对1985年至2001年间在塔塔纪念医院诊断为食管小细胞癌的所有患者进行了回顾性研究。我们检索并分析了有关人口统计学细节、诊断、分期、治疗类型和总生存期的数据。
对18例诊断为食管小细胞癌的患者进行了分析，患者平均年龄62岁（范围48至80岁）。该组包括13名男性和5名女性。18例患者中有7例（39%）出现转移性疾病，其中5例（28%）有肝转移。4例患者接受了手术治疗，联合或不联合化疗或放疗。3例患者接受了同步放化疗，2例患者仅接受化疗，5例患者仅接受放疗。4例晚期疾病且一般状况较差的患者未接受任何治疗。我们患者的总体中位生存期为6个月。接受手术和化疗的患者总体生存期较好。
食管小细胞癌应被视为一种远处转移失败率高的全身性疾病。因此，治疗策略必须将全身化疗与根治性手术或放疗相结合，作为多模式治疗方法的一部分。
