The Role of Surgery in Treating Resectable Limited Disease of Esophageal Neuroendocrine Carcinoma
- 141 Downloads
Esophageal neuroendocrine carcinoma (NEC) is a rare malignant tumor. The role of surgery in resectable limited disease of esophageal NEC remains unclear. How to select a specific group of limited disease of esophageal NEC who might benefit from surgery remains to be answered.
Patients undergoing esophagectomy for resectable limited disease of esophageal NEC in our department from January 2007 to June 2015 were analyzed. TNM staging system was applied to describe those patients, and according to their different long-term prognosis after surgery, those patients were subgrouped into surgery response limited disease (SRLD) group and surgery non-response limited disease (SNRLD) group. Both univariate and multivariate analyses were applied to identify potential prognostic factors.
A total of 72 patients with resectable limited disease of esophageal NEC were identified for analysis. The median survival time of those patients was 21.5 months. There was no significant survival differences among stage I, stage IIA, and stage IIB patients, but all these patients had significantly longer survival than stage III patients. Therefore, stage I, stage IIA, and stage IIB patients were aggregated together as SRLD group, and stage III patients were aggregated as SNRLD group. SRLD patients obtained significantly longer survival than SNRLD patients in both univariate analysis and multivariate analysis. Moreover, adjuvant therapy could significantly benefit SRLD patients (P = 0.004) but could not benefit SNRLD patients (P = 0.136).
Different responses to surgery existed in resectable limited disease of esophageal NEC indicating the need of further subgrouping for those patients. The resectable limited disease of esophageal NEC could be further subgrouped into SRLD group and SNRLD group according to the TNM staging system.
This work was supported by National Natural Science Foundation of China [Nos. 81672291; 31071210] (to Yi-Dan Lin).
Compliance with ethical standards
Conflict of interests
- 3.Modlin IM, Oberg K, Chung DC et al (2008) Gastroenteropancreatic neuroendocrine tumours. Lancet Oncol 9:61–72Google Scholar
- 9.Situ D, Lin Y, Long H et al (2013) Surgical treatment for limited-stage primary small cell cancer of the esophagus. Ann Thorac Surg 95:1057–1062Google Scholar
- 11.Chen SB, Yang JS, Yang WP et al (2011) Treatment and prognosis of limited disease primary small cell carcinoma of esophagus. Dis Esophagus 24:114–119Google Scholar
- 12.Meng MB, Zaorsky NG, Jiang C et al (2013) Radiotherapy and chemotherapy are associated with improved outcomes over surgery and chemotherapy in the management of limited-stage small cell esophageal carcinoma. Radiother Oncol 106:317–322Google Scholar
- 13.Chen WW, Wang F, Chen S et al (2014) Detailed analysis of prognostic factors in primary esophageal small cell carcinoma. Ann Thorac Surg 97:1975–1981Google Scholar
- 15.Maru DM, Khurana H, Rashid A et al (2008) Retrospective study of clinicopathologic features and prognosis of high-grade neuroendocrine carcinoma of the esophagus. Am J Surg Pathol 32:1404–1411Google Scholar
- 19.Lu XJ, Luo JD, Ling Y et al (2013) Management of small cell carcinoma of esophagus in China. J Gastrointest Surg 17:1181–1187Google Scholar
- 21.Lv J, Liang J, Wang J et al (2008) Primary small cell carcinoma of the esophagus. J Thorac Oncol 3:1460–1465Google Scholar
- 22.de Hoyos A, DeCamp MM (2014) Surgery for small cell lung cancer. Thorac Surg Clin 24:399–409Google Scholar
- 23.Hudson E, Powell J, Mukherjee S et al (2007) Small cell oesophageal carcinoma: an institutional experience and review of the literature. Br J Cancer 96:708–711Google Scholar