Xie M R, Xu S B, Sun X H, Ke L, Mei X Y, Liu C Q, Ma D C
Department of Thoracic Surgery, Anhui Provincial Hospital affiliated, Anhui Medical University, Hefei, Anhui, China.
Dis Esophagus. 2015 Jul;28(5):476-82. doi: 10.1111/dote.12230. Epub 2014 May 2.
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.
食管小细胞癌（SCCE）是一种罕见的、侵袭性很强的肿瘤，其特点是早期扩散且预后较差。手术、化疗和放疗已单独或联合用于治疗这种罕见疾病。这项回顾性研究的目的是分析在一个大型中心手术在局限性SCCE治疗中的作用。我们回顾性评估了1994年1月至2011年12月在我们中心接受食管切除术的73例局限性SCCE患者。分析了其临床特征、中位生存时间（MST）、总生存期（OS）及相关预后因素。总体MST为23.0个月，1年、2年、3年和5年OS率分别为61.6%、47.9%、22.7%和10.6%。无淋巴结受累患者的MST（33.0个月）大于有淋巴结受累患者的MST（17.0个月）（P = 0.014）。同样，接受根治性切除的患者的MST（25.0个月）大于接受姑息性切除的患者（7.0个月）（P = 0.004）。接受化疗的患者的MST（27.0个月）大于未接受化疗的患者（13.0个月）（P = 0.021）。生存分析证实根治性手术、化疗和淋巴结受累是独立的预后因素。这项研究表明，对于局限性SCCE患者，尤其是区域淋巴结阴性的患者，应推荐根治性切除联合化疗。无淋巴结转移是一个良好的预后因素，因为无淋巴结受累的患者有更长的总生存期。
