Clinical features of primary small cell carcinoma of the thoracic esophagus: a retrospective analysis of 12 surgically resected cases

Abstract

Aim. Primary esophageal small cell carcinoma is a comparatively rare disease. It is thought to have a poor prognosis, and no standard treatment strategy has yet been established. Surgical cases of small cell carcinoma of the thoracic esophagus were reviewed with regard to clinical characteristics and treatment strategy. Patients and methods. Among the 993 patients who underwent an esophagectomy for thoracic esophageal cancer from 1965 to 2007, 12 cases (1.2%) demonstrated a diagnosis of small cell carcinoma based on the histopathology fi ndings. Results. There were 3 cases of Stage I, 1 case of Stage II, 4 cases of Stage III, and 4 cases of Stage IVa. Five cases (42%) were treated preoperatively (chemoradiotherapy, 4 cases; radiotherapy, 1 case), and the pathological criteria for the effects of preoperative therapy were 3 cases of Grade 3. Eleven patients died of cancer; only 1 patient achieved long-term survival and complete response for treatment with chemoradiation after recurrence. The median survival time was 7.6 months, the 1-year survival rate was 33%, and the 3-year survival rate was 8.3%. Conclusions. The prognosis of surgically resected cases of esophageal small cell carcinoma is poor; therefore, either chemotherapy or chemoradiotherapy should be administered to such cases. Furthermore, improved understanding of the biological characteristics of this type of tumor will result in the development of new therapeutic strategies, which are expected to improve patient outcome.

Neuroendocrine Carcinomas of the Gastroenteropancreatic System: A Comprehensive Review

“…Smoking and excessive alcohol consumption is often seen in patients with SCEC [ 136 , 144 , 145 , 147 , 150 , 154 , 168 , 171 , 175 , 178 , 180 , 181 ]. Tumours range in size from a few centimetres to 17 cm in length and are most frequently found in the middle and lower parts of the oesophagus [ 135 , 137 , 138 , 139 , 142 , 143 , 144 , 146 , 150 , 151 , 152 , 155 , 160 , 165 , 166 , 168 , 169 , 171 , 172 , 174 , 175 , 176 , 178 ], though tumours of the upper oesophagus also occur [ 95 , 135 , 137 , 139 , 143 , 144 , 145 , 146 , 147 , 149 , 150 , 151 , 152 , 153 , 154 ,…”

“…aiding in staging the cancer. Various staging systems have been used in the literature, most commonly the Veterans’ Administration Lung Study Group (VALSG) classification with limited or extensive disease [ 139 ], the American Joint Committee on Cancer criteria (AJCC) [ 164 ], the International Union against Cancer criteria (UICC) [ 177 ], or in some Japanese studies; the Japanese Classification of Esophageal Cancer [ 176 ]. The WHO Classification of 2010 recommends the AJCC staging system for most oesophageal neoplasms [ 20 ].…”

Treatment and prognosis of limited disease primary small cell carcinoma of esophagus

“…Treatments such as surgical resection, radiation therapy, and chemotherapy have been used alone or in combination. Nevertheless, no standard treatment has been established, and there are only limited reports of long‐term survival 1,3 . The significance of surgical treatment is still controversial.…”

“…Nevertheless, no standard treatment has been established, and there are only limited reports of long-term survival. 1,3 The significance of surgical treatment is still controversial. Some reports have emphasized that surgery should be avoided for patients with advanced disease.…”

Case report of aggressive treatments for large-cell neuroendocrine carcinoma of the esophagus

“…At this time, only a small number of retrospective studies with small cohorts and several case reports covering treatment outcomes of large-cell NEC of the esophagus are available [1,[5], [6], [7], [8]]. The reported prognostic outcome is poor because of its high malignant potential [5]. Several comparatively long-term survivors were reported who had been treated by surgery or surgery plus adjuvant chemotherapy [6,7].…”