Dai W, Liu M, Zhuang X, Li Q, Wang D
Department of Thoracic Surgery, Sichuan Cancer Hospital, Chengdu, China.
Department of Thoracic Surgery, Cancer Hospital of Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, 100021, China.
Clin Transl Oncol. 2016 May;18(5):515-20. doi: 10.1007/s12094-015-1398-4. Epub 2015 Sep 2.
Mediastinal small cell carcinoma (MSCC) is a rare tumor with limited published literature. In view of diagnostic confusion pertaining to this tumor, we investigated its origin, clinical features, management and survival.
Clinical data of MSCC patients were retrospectively reviewed. Eligible patients showed pathologically proven small cell carcinoma (SCC) with the primary lesions confined to the mediastinum. Survival information was collected through follow-up studies.
Among 25 MSCC patients identified, 22 were classified to have limited disease (LD), while 3 were with extensive disease (ED). The 5 patients (20%) underwent surgery and 20 patients (80%) underwent non-surgical treatment. The 4 patients with LD MSCC received chemotherapy alone, while 13 of them received chemoradiotherapy. Overall median survival time (MST) of all patients was 22 months, and the 1-, 3- and 5-year overall survival rates were 67.4, 16.8, and 8.4%, respectively. The MST of LD and ED patients separately was 23 and 8 months, respectively, with significant difference (P = 0.005). But, the MST of patients who received surgical and non-surgical treatment was 25 and 21 months, respectively, with no significant difference (P = 0.757). The MST of LD patients receiving chemotherapy and chemoradiotherapy was 12 and 29 months, respectively, but somehow did not show significant difference (P = 0.482).
Our data suggested that MSCC may be a separate clinical entity like extrapulmonary small cell carcinomas (EPSCCs). Despite, multimodal treatment is currently the main treatment option, but for patients with LD MSCC, chemoradiotherapy is recommended to be preferred treatment modality.
纵隔小细胞癌（MSCC）是一种罕见肿瘤，相关文献报道有限。鉴于对此类肿瘤的诊断存在混淆，我们对其起源、临床特征、治疗及生存情况进行了研究。
对MSCC患者的临床资料进行回顾性分析。符合条件的患者病理证实为小细胞癌（SCC），且原发灶局限于纵隔。通过随访研究收集生存信息。
在确诊的25例MSCC患者中，22例被归类为局限性疾病（LD），3例为广泛性疾病（ED）。5例患者（20%）接受了手术治疗，20例患者（80%）接受了非手术治疗。4例LD MSCC患者仅接受了化疗，其中13例接受了放化疗。所有患者的总中位生存时间（MST）为22个月，1年、3年和5年总生存率分别为67.4%、16.8%和8.4%。LD和ED患者的MST分别为23个月和8个月，差异有统计学意义（P = 0.005）。但是，接受手术和非手术治疗患者的MST分别为25个月和21个月，差异无统计学意义（P = 0.757）。接受化疗和放化疗的LD患者的MST分别为12个月和29个月，但差异无统计学意义（P = 0.482）。
我们的数据表明，MSCC可能是一种独立的临床实体，类似于肺外小细胞癌（EPSCC）。尽管目前多模式治疗是主要的治疗选择，但对于LD MSCC患者，建议首选放化疗作为治疗方式。
