Primary Small Cell Carcinoma of the Esophagus

Lv, Jima; Liang, Jun; Wang, Jinwan; Wang, Lühua; He, Jié; Xiao, Zefen; Yin, Wei-bo

doi:10.1097/jto.0b013e31818e1247

Cited by 80 publications

(107 citation statements)

References 15 publications

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“…Small cell neuroendocrine carcinoma (SCNEC) is a rare disease with aggressive and malignant biological behavior and a poor prognosis. SCNEC accounts for 1.0 to 2.8% of all esophageal cancers (2,3). A new classification of neuroendocrine tumors that included SCNEC was introduced by the World Health Organization (WHO) in 2010 (4).…”

Section: Introductionmentioning

confidence: 99%

Second-line chemotherapy for refractory small cell neuroendocrine carcinoma of the esophagus that relapsed after complete remission with irinotecan plus cisplatin therapy: Case report and review of the literature

et al. 2012

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Abstract. Small cell esophageal carcinoma is a type of small cell neuroendocrine carcinoma (SCNEC). SCNEC follows an aggressive clinical course and has a poor prognosis despite multidisciplinary therapies. A standard therapeutic strategy, including surgery, radiation and first-/second-line chemotherapy, has not yet been established for SCNEC. We present a case of SCNEC of the esophagus. A 66-year-old male with SCNEC as extensive disease was treated with 60 mg/m 2 cisplatin on day 1 plus 60 mg/m 2 irinotecan on days 1, 8 and 15 every 4 weeks (IP) with successful complete remission. After the sixth course of IP, increasing pro-gastrin-releasing peptide (ProGRP) and nonspecific enolase (NSE) levels and intense fluorodeoxyglucose (FDG) avidity in a lymph node around the celiac artery (SUV max , 8.3) indicated a refractory relapse of the disease. The patient was treated with three courses of amrubicin (AMR, 35 mg/m 2 ) administered intravenously for 3 consecutive days every 3 weeks as a second-line chemotherapy. The ProGRP and NSE levels returned to the normal range 1 month after the initiation of second-line chemotherapy. However, the ProGRP and NSE levels were elevated after the third course of AMR, and PET-CT revealed progressive disease with liver metastasis and extended lymph node metastasis. As the patient remained asymptomatic, paclitaxel (100 mg/m 2 ) was started as third-line chemotherapy. Patients with SCNEC of the esophagus with extensive disease should be treated with aggressive chemotherapy rather than surgery or radiation monotherapy. In the present case, tumor markers such as ProGRP and NSE were predictive of relapse and PET-CT was used to detect relapse. Further research is required to identify and exploit promising agents for resistant SCNEC.

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Section: Introductionmentioning

confidence: 99%

Second-line chemotherapy for refractory small cell neuroendocrine carcinoma of the esophagus that relapsed after complete remission with irinotecan plus cisplatin therapy: Case report and review of the literature

et al. 2012

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“…11 24 32 Some authors have recommended surgery for patients with LD, 8 and Lv, et al 2 reported MST analysis based on the therapeutic method. However, their conclusions were controversial, with Chen, et al reporting surgery with chemotherapy as an independent prognostic factor, 10 and Lv reporting chemotherapy as an independent prognostic factor.…”

Section: -3 8-9 13 16 19-20 21 24mentioning

confidence: 99%

“…However, their conclusions were controversial, with Chen, et al reporting surgery with chemotherapy as an independent prognostic factor, 10 and Lv reporting chemotherapy as an independent prognostic factor. 2 Multidrug combination chemotherapy seems effective with or without surgery. Vos reported that chemotherapy prolonged MST from 9.5 months (interquartile range [IQR], 6-14 months) to 6 months (IQR, 4-7 months) in ED, and concurrent CRT prolonged MST from 36 months (IQR, 14-93 months) to 11 months (IQR, 9-15 months) in LD compared with nonconcurrent chemotherapy and radiotherapy.…”

Section: -3 8-9 13 16 19-20 21 24mentioning

confidence: 99%

“…[1][2][3][4][5][6][7] In addition, SCCE displays 26 Few reports of large series have been reported to date because of the rarity of this entity. Optimal treatment for this tumor has yet to be defined, because of the lack of any comprehensive description of SCCE, and surgery, chemotherapy, radiotherapy, or a combination might be performed empirically, with no promise of efficacy.…”

Section: Introductionmentioning

confidence: 99%

“…[1][2][3][4][5][6][7] In addition, SCCE displays aggressive progression and an extremely unfavorable prognosis. 1-4 6 8-25 McKeown first reported two cases of SCCE in 1952.…”

Section: Introductionmentioning

confidence: 99%

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Successful Chemoradiotherapy for Small-Cell Carcinoma of the Esophagus in an Octogenarian Japanese Woman: Report of the Oldest Case and Review of Long-Term Survival Cases

Shinohara

Takeno

Takahashi

et al. 2014

ATCS

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Small-cell carcinoma of the esophagus (SCCE) is a rare and rapidly progressive malignant tumor with an extremely unfavorable prognosis. We report a case of long-term survival and review similar cases in the literature. An 84-year-old Japanese woman visited a clinic complaining of tarry stools. Type-1 tumor was detected in the left posterior wall of the middle thoracic esophagus on endoscopic examination, and the pathological diagnosis following immunohistochemical examination was SCCE. Chemoradiotherapy was adopted after taking the characteristics of poor prognosis, rapid progression, and patient age into consideration. Chemoradiotherapy comprised 56 Gy of irradiation over 43 days and two courses chemotherapy with cisplatin and vincristine. Therapeutic effect was evaluated as complete response after endoscopic examination and computed tomography at one month after treatment. No recurrence or metastasis has been identified as of more than five years after achieving complete response, with endoscopic examination every six months and computed tomography every three months. To date, long-term survival has only been reported in octogenarian patients with SCCE, and the present case describes the oldest patient for whom successful radical therapy has been reported.Keywords: small-cell carcinoma, esophagus, chemoradiotherapy, octogenarian, cisplatin, vincristine IntroductionSmall-cell carcinoma of the esophagus (SCCE) is an uncommon disease, accounting for 0.05-3.1% of all esophageal cancers. [1][2][3][4][5][6][7] In addition, SCCE displays 26 Few reports of large series have been reported to date because of the rarity of this entity. Optimal treatment for this tumor has yet to be defined, because of the lack of any comprehensive description of SCCE, and surgery, chemotherapy, radiotherapy, or a combination might be performed empirically, with no promise of efficacy.Similarly, the epidemiological risk factors for SCCE remain uncertain. Alcohol and smoking are commonly regarded as potential risk factors, but no clear correlations have been demonstrated in previous epidemiological studies. 17 27We report an octogenarian patient with SCCE who has achieved complete remission lasting more than Small-cell carcinoma of the esophagus (SCCE) is a rare and rapidly progressive malignant tumor with an extremely unfavorable prognosis. We report a case of long-term survival and review similar cases in the literature. An 84-year-old Japanese woman visited a clinic complaining of tarry stools. Type-1 tumor was detected in the left posterior wall of the middle thoracic esophagus on endoscopic examination, and the pathological diagnosis following immunohistochemical examination was SCCE. Chemoradiotherapy was adopted after taking the characteristics of poor prognosis, rapid progression, and patient age into consideration. Chemoradiotherapy comprised 56 Gy of irradiation over 43 days and two courses chemotherapy with cisplatin and vincristine. Therapeutic effect was evaluated as complete response after endoscopic examination and computed ...

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National Cancer Database report of nonmetastatic esophageal small cell carcinoma

et al. 2018

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BackgroundEsophageal small cell carcinoma (ESCC) is a rare malignancy for which there is no consensus management approach. This is the largest known analysis of nonmetastatic ESCC patients to date, evaluating national practice patterns and outcomes of surgical‐based therapy vs chemoradiotherapy (CRT) vs chemotherapy alone.MethodsThe National Cancer Data Base was queried for esophageal cancer patients with histologically confirmed nonmetastatic ESCC. Univariable and multivariable logistic regression ascertained factors associated with receipt of surgical‐based management. Kaplan‐Meier analysis evaluated overall survival (OS) and the log‐rank test is used to compare OS between groups; Cox univariate and multivariate analyses determined variables associated with OS.ResultsAltogether, 323 patients were analyzed; 64 (20%) patients underwent surgical‐based therapy, 211 (65%) CRT, and 48 (15%) chemotherapy alone. On multivariable analysis, no single factor significantly predicted for administration of surgery. Despite no OS differences between the surgery‐based (median OS 21 months) and CRT arms (18 months), both were superior to CT alone (10 months) (P < 0.001). Among other factors, receiving any local therapy independently predicted for higher OS over chemotherapy alone on Cox multivariate analysis (P < 0.001).ConclusionsThis study of a large, contemporary national database demonstrates that most ESCC is treated with CRT in the United States; adding local therapy to systemic therapy may be beneficial to these patients, although individualized multidisciplinary management is still recommended.

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Primary Small Cell Carcinoma of the Esophagus

Abstract: SCEC is systemic disease. Tumor stage and chemotherapy were independent prognostic factors. Systemic therapy, based on chemotherapy with radiotherapy, is recommended.

Cited by 80 publications

References 15 publications

Second-line chemotherapy for refractory small cell neuroendocrine carcinoma of the esophagus that relapsed after complete remission with irinotecan plus cisplatin therapy: Case report and review of the literature

Second-line chemotherapy for refractory small cell neuroendocrine carcinoma of the esophagus that relapsed after complete remission with irinotecan plus cisplatin therapy: Case report and review of the literature

Successful Chemoradiotherapy for Small-Cell Carcinoma of the Esophagus in an Octogenarian Japanese Woman: Report of the Oldest Case and Review of Long-Term Survival Cases

National Cancer Database report of nonmetastatic esophageal small cell carcinoma

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