Casas F, Ferrer F, Farrús B, Casals J, Biete A
Radiation Oncology Department, Hospital Clinic i Provincial, Barcelona, Spain.
Cancer. 1997 Oct 15;80(8):1366-72.
Few studies of patients with esophageal small cell carcinoma (SCC) have been conducted. Choice of treatment remains controversial.
The authors analyzed data on 199 evaluable esophageal SCC patients, selected from among 230 patients found in the literature, and a data extraction form that recorded 11 features was completed. To allow for the evaluation of prognostic factors that influenced survival, the patients were grouped according to limited stage (LS), which was defined as disease confined to the esophagus, or extensive stage (ES), which was defined as disease that had spread beyond locoregional boundaries. Univariate and multivariate analyses were performed. Treatment was categorized as either local or local with systemic; for the ES cases, the categories were defined as treatment versus no treatment.
The tumor site was described in 178 cases (89%). Mean tumor size was 6.1. Pure SCC was found in 137 cases (68.8%), whereas 62 cases (31.2%) showed mixed SCC; 93 (46.7%) were LS, whereas 95 (47.7%) were ES. In 11 cases (5.5%), the stage was not determined. There was a significant difference in survival between patients with LS and those with ES (P < 0.0001). The median survival was 8 months for patients with LS and 3 months for those with ES. Univariate analysis of LS showed 3 significant prognostic factors: age (for patients age < or =60 years, the median survival was 11 months, whereas for those age >60 years, the median survival was 6 months), tumor size (for those with tumors < or =5 cm, the median survival was 12 months, whereas for those with tumors >5 cm, the median survival was 4 months), and type of treatment (with local plus systemic treatment, the median survival was 20 months, whereas with local it was 5 months). In multivariate analysis, tumor size (P = 0.007) and type of treatment (P < 0.001) were shown to be independent predictive variables.
Esophageal SCC is an aggressive type of tumor. This study shows that there are significant differences between LS and ES and that in LS, both tumor size and type of treatment are possible prognostic factors.
针对食管小细胞癌（SCC）患者的研究较少。治疗方案的选择仍存在争议。
作者分析了从文献中找到的230例患者中选取的199例可评估的食管SCC患者的数据，并完成了一份记录11项特征的数据提取表。为了评估影响生存的预后因素，根据局限期（LS）对患者进行分组，局限期定义为疾病局限于食管，或广泛期（ES），广泛期定义为疾病已扩散至局部区域边界以外。进行了单因素和多因素分析。治疗分为局部治疗或局部联合全身治疗；对于广泛期病例，类别定义为治疗与未治疗。
178例（89%）描述了肿瘤部位。平均肿瘤大小为6.1。137例（68.8%）为纯SCC，而62例（31.2%）为混合性SCC；93例（46.7%）为局限期，而95例（47.7%）为广泛期。11例（5.5%）未确定分期。局限期患者和广泛期患者的生存存在显著差异（P < 0.0001）。局限期患者的中位生存期为8个月，广泛期患者为3个月。局限期的单因素分析显示3个显著的预后因素：年龄（年龄≤60岁的患者，中位生存期为11个月，而年龄>60岁的患者，中位生存期为6个月）、肿瘤大小（肿瘤≤5 cm的患者，中位生存期为12个月，而肿瘤>5 cm的患者，中位生存期为4个月）以及治疗类型（局部加全身治疗，中位生存期为20个月，而局部治疗为5个月）。多因素分析显示，肿瘤大小（P = 0.007）和治疗类型（P < 0.001）是独立的预测变量。
食管SCC是一种侵袭性肿瘤。本研究表明局限期和广泛期之间存在显著差异，并且在局限期，肿瘤大小和治疗类型均可能是预后因素。
