Detailed Analysis of Prognostic Factors in Primary Esophageal Small Cell Carcinoma
Detailed Analysis of Prognostic Factors in Primary Esophageal Small Cell Carcinoma
复制标题
原发性食管小细胞癌预后因素的详细分析
DOI：
10.1016/j.athoracsur.2014.02.037
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发表时间：
2014-06-01
影响因子：
4.6
通讯作者：
Xu, Rui-Hua
中科院分区：
文献类型：
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作者：
Chen, Wei-Wei;Wang, Feng;Xu, Rui-Hua
背景原发性食管小细胞癌（SCCE）的特点是高度侵袭性，预后差。为了确定潜在的预后因素并评估手术、化疗和放疗在SCCE中的作用，我们回顾性分析了来自中国三家大型机构的SCCE患者。所有1998 - 2012年的SCCE患者均来自中山大学肿瘤防治中心、北京协和肿瘤医院和汕头肿瘤医院的三个临床数据库。采用单因素分析和考克斯回归模型分析潜在的预后因素。采用基于2002年美国癌症联合委员会食管癌分期系统的亚组分析来检查治疗对生存率的影响。在I/II期SCCE患者中，85%的患者接受了手术，并显示出生存期改善（中位生存时间[MST] 29 vs 17.4个月，p =0.082）。然而，化疗并没有进一步提高生存率。在IIB/III期SCCE患者中，化疗而非手术改善了生存期（MST 13.0 vs 6.1个月，p =0.003），放疗改善了生存期。在IV期患者中，化疗可提高生存期（MST 12.5 vs 4.0个月，p < 0.001），化疗联合放疗上级单纯化疗（MST 13.2 vs 8.9个月，p =0.014）。对于I/IIA期患者，可建议单独进行外科手术。对于IIB期或以上的患者，化疗应是主要的治疗方法，化疗联合放疗倾向于提高生存率。(C)2014年由胸外科医师协会
Background. Primary small cell carcinoma of the esophagus (SCCE) is characterized as highly aggressive with a poor prognosis. To identify potential prognostic factors and to assess the role of surgical procedures, chemotherapy, and radiotherapy for SCCE, we retrospectively analyzed patients with SCCE from three large institutions in China.Methods. All of the SCCE patients between 1998 and 2012 were identified from three clinical databases of the Sun Yat-Sen University Cancer Center, Peking Union Cancer Hospital and Shantou Cancer Hospital. Potential prognostic factors were analyzed with univariate analysis and a Cox regression model. Subgroup analysis based on the 2002 American Joint Committee on Cancer staging system for esophageal cancer was applied to examine the effect of treatment on survival.Results. In patients with stage I/II SCCE, 85% underwent operations and showed improved survival (median survival time [MST] 29 vs 17.4 months, p =0.082). However, chemotherapy did not further improve survival. In patients with stage IIB/III SCCE, chemotherapy, instead of operation, improved survival (MST 13.0 vs 6.1 months, p =0.003), and radiotherapy resulted in improved survival. In stage IV patients, chemotherapy improved survival (MST 12.5 vs 4.0 months, p < 0.001), and chemotherapy combined with radiotherapy was superior to chemotherapy alone (MST 13.2 vs 8.9 months, p =0.014).Conclusions. Surgical procedures alone can be recommended for stage I/IIA patients. In patients with stage IIB disease or above, chemotherapy should be the main treatment approach, and chemotherapy combined with radiotherapy tended to improve survival. (C) 2014 by The Society of Thoracic Surgeons