Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan.
Department of Surgical Oncology, Hiroshima University, Hiroshima, Japan;
Anticancer Res. 2023 Jul;43(7):3289-3293. doi: 10.21873/anticanres.16504.
BACKGROUND/AIM: Malignant esophageal neuroendocrine carcinoma (ENEC) is rare, and its prognosis is poor. Therefore, a standard strategy for treating ENEC remains controversial, and few reports have described a pathological complete response of ENEC to neoadjuvant chemotherapy (NAC) followed by surgery.
A 74-year-old woman presented with an esophageal tumor, discovered as a result of dysphagia, that was clinically diagnosed as ENEC (small-cell type). The clinical stage was cT2N1M0 stage II (Union for International Cancer Control, eighth edition). Two cycles of carboplatin and etoposide were administered as NAC, and the overall treatment response to NAC was judged as a partial response according to Response Evaluation Criteria for Solid Tumors v.1.1. The patient then underwent robot-assisted, minimally-invasive esophagectomy with thoracoabdominal lymph node dissection. Postoperative histopathology revealed no residual tumor or lymph node metastasis, and pathological complete response to NAC was achieved. The postoperative course was free of major complications, and the patient has remained recurrence-free for 1 year.
We treated ENEC with NAC and robotic surgery. To our knowledge, this is the first report of a pathological complete response for ENEC after NAC with carboplatin and etoposide.
背景/目的：恶性食管神经内分泌癌（ENEC）罕见，预后较差。因此，ENEC 的标准治疗策略仍存在争议，很少有报道描述过 ENEC 对新辅助化疗（NAC）联合手术的病理完全缓解。
一名 74 岁女性因吞咽困难发现食管肿瘤，临床诊断为 ENEC（小细胞型）。临床分期为 cT2N1M0 Ⅱ期（国际抗癌联盟第八版）。给予两周期卡铂和依托泊苷作为 NAC，根据实体瘤反应评估标准 1.1 评估 NAC 的总体治疗反应为部分缓解。患者随后接受了机器人辅助微创食管切除术和胸腹淋巴结清扫术。术后组织病理学检查未见肿瘤残留或淋巴结转移，达到 NAC 的病理完全缓解。术后过程无重大并发症，患者无复发，随访 1 年。
我们采用 NAC 和机器人手术治疗 ENEC。据我们所知，这是首例报道使用卡铂和依托泊苷治疗后 ENEC 达到病理完全缓解的病例。
