Analysis of the clinical and epidemiological changes, treatments, and prognoses of pri-mary esophageal small cell carcinoma
10.3969/j.issn.1000-8179.2016.13.258
- VernacularTitle:529例食管原发小细胞癌临床流行病学特征及治疗和预后分析
- Author:
Tangjuan ZHANG
;
Yin LI
;
Weili HAN
;
Hailing WANG
;
Tao JIANG
;
Jingli REN
;
Jianxue YANG
;
Haizhou GUO
;
Hui MENG
;
Hui MENG
;
Jianliang LU
;
Xi CHEN
;
Wenting FU
;
Lidong WANG
- Publication Type:Journal Article
- Keywords:
esophageal cancer;
small cell carcinoma;
epidemiology treatment;
survival rate;
misdiagnosis
- From:
Chinese Journal of Clinical Oncology
2016;43(13):571-576
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To characterize the clinical and epidemiological changes, treatments, and prognoses of primary esophageal small cell carcinoma (PESC). Methods:A retrospective analysis was conducted using the clinical epidemiology data of 529 PESC patients se-lected from the clinical databases of 500,000 esophageal and gastric cardiac carcinomas of the Henan Key Laboratory for Esophageal Cancer Research (1992-2015). Among these patients, 241 cases were included in the survival analysis. The five-year survival rate was calculated using Kaplan-Meier analysis, and the differences in survival rates were compared using the Log-rank analysis model. Re-sults:All 529 PESC cases were analyzed, which accounted for 0.2%of esophageal cancers diagnosed in the same period. The incidence of PESC increased annually (R2=0.574). The survival rates for 1-, 2-, 3-, and 5-year of 241 PESC patients were 55%, 40%, 29%, and 9%, respectively, and the median survival time was 21.9 months. On the basis of the VALSG criteria of lung small cell carcinoma, a statisti-cal difference was observed in the overall survival rates for limited and extensive diseases (P=0.003), with the median survival time of 24.3 and 17.5 months, respectively. Furthermore, significant differences were observed on survival with various treatment modalities (P=0.004). The median survival time of PESC patients treated with combined surgery and radiochemotherapies (28.8 months) was lon-ger than those with either chemotherapy (17.8 months, P=0.015) or chemoradiotherapy (14.5 months, P=0.004). In limited disease pa-tients, the median survival time was longer in patients treated with surgery (27.7 months) than in those without surgery (16.2 months, P=0.007). Notably, the biopsy diagnosis before surgery for PESC was only 40.8%. Conclusion:PESC is a rare malignant carcinoma with increasing incidence. PESC presents poor prognosis, and the survival rate can be improved through combined therapies based on sur-gery. A high misdiagnosis rate for PESC is observed before surgery with biopsy.
