Al Mansoor Saineb, Ziske Carsten, Schmidt-Wolf Ingo G H
Department of Internal Medicine III, University of Bonn, Germany.
Ger Med Sci. 2013 Aug 23;11:Doc12. doi: 10.3205/000180. eCollection 2013.
We analysed the typical features of primary small cell carcinoma of the esophagus (SCCE) with emphasis on occurrence, behaviour, outcome and treatment options. This metaanalysis was aimed at collecting and analyzing information from international studies about handling this disease. This seems necessary due to the rarity of this disease. Studies were acquired from electronic databases and reference lists. We finally analysed 313 patient cases from the literature with oesophageal SCC. A data extraction was accomplished referring to 13 evaluable features that are described in the "methods", whereof 7 were analyzed with univariate and multivariate tests. Three hundred thirteen cases were analyzed, 109 patients (35%) had limited stage (LS), whereas 167 (54%) had extensive stage (ES). There is no information about the remaining 35 patients concerning the stage. Univariate and multivariate analysis showed only age (<50 years vs. >50 years, HR 1.024; 95% CI 1.000-1.041, P<0.0001) and disease stage (LS vs. ES, HR 4.884; 95% CI 2.572-9.27, P<0.0001) as significant prognostic factors. There also was a statistically significant difference in survival between those patients who received therapy compared to those who only received best supportive care (11.6 months vs. 0.8 months, HR 0.093, CI 95% 0.053-0.16, P<0.001). In this first multivariate analysis for SCCE we show that SCCE is an aggressive type of tumour with a shorter survival rate compared to its counterpart from the lung. It is demonstrated that only disease stage (limited vs. extensive stage), age (<50 years vs. >50 years) and therapy are independent significant predictors of prognosis.
我们分析了原发性食管小细胞癌（SCCE）的典型特征，重点关注其发生、行为、预后及治疗选择。这项荟萃分析旨在收集和分析来自国际研究中有关处理该疾病的信息。鉴于该疾病的罕见性，这似乎很有必要。研究通过电子数据库和参考文献列表获取。我们最终分析了文献中313例食管SCC患者病例。参照“方法”中描述的13项可评估特征进行数据提取，其中7项通过单变量和多变量检验进行分析。共分析了313例病例，109例患者（35%）为局限期（LS），而167例（54%）为广泛期（ES）。其余35例患者的分期信息缺失。单变量和多变量分析显示，仅年龄（<50岁与>50岁，HR 1.024；95%CI 1.000 - 1.041，P<0.0001）和疾病分期（LS与ES，HR 4.884；95%CI 2.572 - 9.27，P<0.0001）是显著的预后因素。接受治疗的患者与仅接受最佳支持治疗的患者之间的生存率也存在统计学显著差异（11.6个月与0.8个月，HR 0.093，95%CI 0.053 - 0.16，P<0.001）。在首次针对SCCE的多变量分析中，我们表明SCCE是一种侵袭性肿瘤类型，与肺癌相比生存率更低。结果表明，仅疾病分期（局限期与广泛期）、年龄（<50岁与>50岁）和治疗是独立的显著预后预测因素。
