Non-operative management of small cell carcinoma of esophagus

Abstract

Primary small cell carcinoma of the esophagus (SmCC) is an uncommon aggressive tumor characterized by early systemic dissemination and poor prognosis, regardless of the methods of treatment. The optimal treatment strategy remains uncertain. A retrospective study was conducted to review the results of non-operative treatment for patients with limited and metastatic esophageal SmCC. Between 1993 and 2003, 10 patients were diagnosed to have primary esophageal SmCC in our institution. Six of them had disseminated diseases, whereas the other four had limited disease upon diagnosis. All patients were managed non-operatively by either chemotherapy and/or radiotherapy. The overall median survival was 8 months (range, 2-62 months). The survival was 4-62 months for patients with limited disease, whereas it was 2-10 months for patients with disseminated disease at initial diagnosis. In summary, the current study demonstrated satisfactory palliation could be achieved with chemo-radiation for patients with limited disease; however, the ultimate role of primary chemo-radiation for esophageal SmCC must await results from randomized trials.

Neuroendocrine carcinoma of the esophagus: clinical characteristics and prognostic evaluation of 49 cases with surgical resection

“…However, in present study, patients have showed a median survival time of 22.4 months after radical esophagectomy and regional lymphadectomy with or without adjutant therapy for esophageal NEC. To our best knowledge, recently published studies with relatively large cases exploring the role of surgery in treating limited disease stage esophageal NEC have yield a median survival time of 10.1 to 28.5 months (9,16,(22)(23)(24), while patients treated with chemoradiotherapy alone yielded a median survival time of 8.0 to 16.1 months (25)(26)(27). Therefore, it seemed that surgery may benefit patients with limited stage esophageal NEC, but the role of surgery in treating esophageal NEC still remains to be confirmed and validated (28).…”

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

“…Because the frequency of esophageal small cell carcinoma is low, no standard treatment for esophageal small cell carcinoma has been established, and there are only limited reports of long-term survival. It remains controversial whether surgery is necessary, because chemotherapy plays a key role in the treatment for patients with esophageal small cell carcinoma [14]. Surgery may contribute to the long-term survival of patients without nodal metastasis, and patients with nodal metastasis have a better chance of long-term survival if the nodal metastasis is controlled or cured by chemotherapy or radiotherapy before surgery [15].…”

Successful Chemoradiotherapy for Small-Cell Carcinoma of the Esophagus in an Octogenarian Japanese Woman: Report of the Oldest Case and Review of Long-Term Survival Cases

“…18 33 Yau, et al suggested that chemotherapy with radiotherapy should not be recommended as the primary treatment for SCCE until randomized trials have been performed. 3 In our case, CRT was performed according to a regimen for SCCL, using CDDP and VCR. We thought that surgery might prove too invasive, as the patient was 84 years old, although surgery has priority for achieving local control of SCCE.…”

“…[1][2][3][4][5][6][7] In addition, SCCE displays 26 Few reports of large series have been reported to date because of the rarity of this entity. Optimal treatment for this tumor has yet to be defined, because of the lack of any comprehensive description of SCCE, and surgery, chemotherapy, radiotherapy, or a combination might be performed empirically, with no promise of efficacy.…”

“…[1][2][3][4][5][6][7] In addition, SCCE displays aggressive progression and an extremely unfavorable prognosis. 1-4 6 8-25 McKeown first reported two cases of SCCE in 1952.…”