Brega-Massone P P, Conti B, Lequaglie C, Ferro F, Cataldo I
Divisione di Chirurgia Toracica, Istituto Nazionale per lo Studio e la Cura dei Tumori, Milano, Italy.
Minerva Chir. 2003 Aug;58(4):629-32.
Small cell carcinoma of the esophagus is a rare tumor. It was described for the first time in 1952 by McKeown and 200 cases have been reported till now. Because of its similarity with small cell carcinoma of the lung, the treatment of this tumor is controversial. In our Institute we treated three patients with small cell carcinoma of the esophagus. All subjects underwent subtotal esophagectomy with esophagogastroanastomosis through laparotomic and thoracotomic approach. Histologically, the tumor was classified as pure SCEC in one patient and mixed SCEC in the other two. The stage I and II patients received operation as single treatment. The two patients are alive and disease free 219 and 193 months after surgery. The third patient, classified at stage III, underwent postoperative chemotherapy but local and distant recurrence was observed 11 months after surgical resection. He was submitted to a second choice chemotherapy, but he died 24 months after the operation. The long-term survival observed in our two patients treated by surgery is the longest described in literature. Our experience seems to demonstrate that an early diagnosis and oncological radical resection, may be helpful in the long-term prognosis even in presence of a very aggressive neoplasm.
食管小细胞癌是一种罕见的肿瘤。1952年,麦基翁首次对其进行了描述,迄今为止已报告了200例病例。由于其与肺小细胞癌相似,该肿瘤的治疗存在争议。在我们研究所,我们治疗了3例食管小细胞癌患者。所有患者均通过开腹和开胸手术进行了食管次全切除术并食管胃吻合术。组织学上,1例患者的肿瘤被分类为纯食管小细胞癌,另外2例为混合性食管小细胞癌。I期和II期患者接受手术作为单一治疗。这2例患者术后219个月和193个月仍存活且无疾病。第3例患者为III期,术后接受了化疗,但手术切除后11个月出现局部和远处复发。他接受了二线化疗,但术后24个月死亡。我们通过手术治疗的2例患者的长期生存是文献中报道的最长时间。我们的经验似乎表明,即使存在非常侵袭性的肿瘤,早期诊断和肿瘤根治性切除可能有助于长期预后。