title: Multidisciplinary modalities achieve encouraging long-term survival in resectable limited-disease esophageal small cell carcinoma.
abstract: BACKGROUND
  The management of limited-disease esophageal small cell carcinoma is not well defined, and the role of surgery is still controversial. We aim to determine the optimal treatment strategy in limited-disease of esophageal small cell carcinoma.
  
  
  RESULTS
  We conducted a retrospective review of 141 patients with limited-disease esophageal small cell carcinoma from 3 institutions in China who underwent treatment between July 1994 and September 2008, July 1994 and July 2011, and June 2004 and December 2010, respectively. The survival rate was calculated by the Kaplan-Meier method, and the log-rank test was used to assess the survival differences between the groups. Cox proportional hazards model were used to further determine the independent factors impacting overall survival. The median survival time was 16.1 months for the entire cohort of patients, with a 5-year survival rate of 6.7%. The median survival times for surgery alone, surgery combined with chemotherapy, surgery combined with radiotherapy, surgery combined with chemotherapy and radiotherapy, chemotherapy plus radiotherapy, and chemotherapy alone were 18.0 months, 15.0 months, 23.0 months, 25.0 months, 17.1 months, and 6.1 months, respectively; the corresponding 5-year survival rates were 0%, 15.4%, 0%, 38.9%, 0%, and 0%, respectively. For the 105 patients who underwent R0 resection, the median disease-free survival time was 12.0 months, with a 95% confidence interval of 9.5 months to 14.5 months. The multivariate Cox regression analysis demonstrated that advanced pathological staging (p = 0.003), and pure esophageal small cell carcinoma (p = 0.035) were independent factors decreasing overall survival.
  
  
  CONCLUSIONS
  Our data suggested that multidisciplinary modalities achieved encouraging long-term survival in patients with resectable limited-disease of esophageal small cell carcinoma.
authors.affiliation: Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou City, Guangdong Province, People's Republic of China.
authors.forename: Xue
authors.initials: X
authors.lastname: Hou
authors.forename: Jin-Chang
authors.initials: JC
authors.lastname: Wei
authors.forename: Jing-Xun
authors.initials: JX
authors.lastname: Wu
authors.forename: Xin
authors.initials: X
authors.lastname: Wang
authors.forename: Jian-Hua
authors.initials: JH
authors.lastname: Fu
authors.forename: Peng
authors.initials: P
authors.lastname: Lin
authors.forename: Hao-Xian
authors.initials: HX
authors.lastname: Yang
mesh_terms: D000328:Adult; D000368:Aged; D018288:Carcinoma, Small Cell / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D002681:China; D003131:Combined Modality Therapy; D015897:Comorbidity; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000601:surgery / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome