Li Jiangyan, Ma Jun, Wang Hao, Niu Jianyong, Zhou Lin
Department of Laboratory Medicine, Changzheng Hospital, Naval Medical University, Shanghai, China.
Department of Cardiothoracic Surgery, Heji Hospital, Changzhi Medical College, Changzhi, China.
J Thorac Dis. 2020 Jul;12(7):3529-3538. doi: 10.21037/jtd-20-1428.
Small cell cancer (SmCC) of the esophagus is a rare malignancy with an aggressive behavior associated with poor survival. The present study aims to determine the clinicopathological characteristics, therapeutic and prognosis.
Patients with SmCC of the esophagus, diagnosed from 1975 to 2016, were identified from the Surveillance, Epidemiology, and End Results (SEER) database. The clinicopathological characteristics were described and the prognostic factors were further determined using Cox regression analysis.
The median overall survival (mOS) of all 515 patients with SmCC of the esophagus was 7.0 months, and the 1-, 2-, and 5-year survival rates were 31.5%, 14.7%, 6.00%, respectively. Patients with chemoradiotherapy (mOS: 12.0 months) had better prognosis than those receiving surgery alone (mOS: 12.0 4.0 months). The patients receiving surgery combined with chemoradiotherapy had longest survival time (mOS: 19.0 months), followed by patients receiving surgery combined with chemotherapy (14.0 months). The multivariate Cox survival analysis demonstrated that older age, distant metastases were independent prognostic factors. The use of surgery, chemotherapy, radiotherapy were independent favorable prognostic factors (P<0.05 for all).
SmCC of the esophagus is uncommon, older age and distant metastases were independently associated with poor survival. Chemotherapy could provide significant clinical benefit for those patients, especially chemoradiotherapy and surgery combined with chemotherapy.
食管小细胞癌(SmCC)是一种罕见的恶性肿瘤,具有侵袭性,生存率低。本研究旨在确定其临床病理特征、治疗方法及预后情况。
从监测、流行病学和最终结果(SEER)数据库中识别出1975年至2016年诊断为食管SmCC的患者。描述其临床病理特征,并使用Cox回归分析进一步确定预后因素。
515例食管SmCC患者的中位总生存期(mOS)为7.0个月,1年、2年和5年生存率分别为31.5%、14.7%、6.00%。接受放化疗的患者(mOS:12.0个月)比单纯接受手术的患者(mOS:4.0个月)预后更好。接受手术联合放化疗的患者生存时间最长(mOS:19.0个月),其次是接受手术联合化疗的患者(14.0个月)。多因素Cox生存分析表明,年龄较大、远处转移是独立的预后因素。手术、化疗、放疗的使用是独立的有利预后因素(均P<0.05)。
食管SmCC并不常见,年龄较大和远处转移与生存率低独立相关。化疗可为这些患者带来显著的临床益处,尤其是放化疗以及手术联合化疗。