[Primary esophageal small-cell carcinoma].
OBJECTIVE
To study the clinical biocharacteristics of primary esophageal small-cell carcinoma (PESC) and factors influencing prognosis and to find rational surgical indications and combined therapy.


METHODS
To analyse the clinical materials of 47 patients undergone operation with PESC compared with those of patients with esophageal squamous-cell carcinoma(ESCC) or primary esophageal adenocarcinoma (PEAC).


RESULTS
The overal resectability, morbidity and 30-day mortality rate of PESC was 93.6%, 17% and 2.1%, respectively, being similar to those of ESCC or PEAC. TNM staging, lymph node metastasis were the major determinants influencing long-term survival. Tumor length, depth of tumor invasion and type of operation had little influence on long-term prognosis. The 5-year survival rate of PESC was 7.5%, which was much lower than that of ESCC and PEAC (P < 0.01). Among the 42 deceased patents, one died of anastomotic leakage and the others died of remote metastasis and recurrence. Adjuvant chemotherapy did no help improve patients long-term survival.


CONCLUSIONS
Campared with ESCC and PEAC, PESC is the most malignent one with early lymphatic and hematogenous matastases and poor prognosis. Lymph node metastasis is the major factor influencing prognosis. Patients in stage 0, I and II a of PESC are indicated for surgical resection, while those in stage II b, III and IV should be managed with non-surgical combined therapy.
Wang
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Y
Department of Thoracic Surgery, Cancer Institute (Hospital), Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100021.
Zhang
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R
Zhang
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D
D000368:Aged; D018288:Carcinoma, Small Cell / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D004938:Esophageal Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D015996:Survival Rate