title: Effectiveness of neoadjuvant chemotherapy with cisplatin and irinotecan followed by surgery on small-cell carcinoma of the esophagus: A case report.
abstract: BACKGROUND
  Small-cell carcinoma of the esophagus (SCCE) is a rare disease with aggressive progression and a poor prognosis. A standard treatment strategy for SCCE is yet to be established.
  
  
  METHODS
  A 40-year-old woman with dysphagia was admitted to our hospital. A clinical diagnosis of SCCE (T3N1N0 stage IIIA) was established. She was initially treated with chemotherapy using cisplatin (CDDP) and irinotecan (CPT-11). After two courses of treatment, the primary lesion in the esophagus was not detectable by esophageal endoscopy. Likewise, swelling of the right recurrent nerve lymph node present prior to treatment could not be detected. The chemotherapy resulted in a complete response. One month after the conclusion of chemotherapy, radical esophagectomy with three-field lymph node dissection was performed. Histopathological examination of the excised specimen revealed no residual tumor or lymph node metastasis. The patient was discharged from hospital 29 days after surgery with no complications. The patient is alive and has remained cancer-free for 48 months after the surgery.
  
  
  CONCLUSIONS
  Systemic chemotherapy for SCCE in combination with surgery was treated after surgery in most reports. Neoadjuvant chemotherapy is advantageous from three viewpoints, namely achievement of downstaging, increasing complete resection rates, and a better completion of treatment compared with postoperative chemotherapy. Neoadjuvant chemotherapy following esophagectomy could be a useful treatment option for patients with limited disease (LD) of SCCE.
  
  
  CONCLUSIONS
  We report a case of SCCE achieving a pathologically complete response with neoadjuvant chemotherapy using CDDP and CPT-11, and long-term survival followed by surgery.
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan. Electronic address: yakiyama@iwate-med.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Akiyama
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Iwaya
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Shioi
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Fumitaka
authors.initials: F
authors.lastname: Endo
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Takehiro
authors.initials: T
authors.lastname: Chiba
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Koki
authors.initials: K
authors.lastname: Otsuka
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Nitta
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Keisuke
authors.initials: K
authors.lastname: Koeda
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Masaru
authors.initials: M
authors.lastname: Mizuno
authors.affiliation: Division of Molecular Diagnostic Pathology, Department of Pathology, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Noriyuki
authors.initials: N
authors.lastname: Uesugi
authors.affiliation: Department of Palliative Care Medicine, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Yusuke
authors.initials: Y
authors.lastname: Kimura
authors.affiliation: Department of Surgery, Iwate Medical University School of Medicine, Iwate, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Sasaki
keywords: Esophagectomy; Esophagus; Neoadjuvant chemotherapy; Small-cell carcinoma