Small cell carcinoma of the esophagus: a report of 16 cases from a single institution and literature review.

BACKGROUND

The optimum treatment for small cell carcinoma of the esophagus (SCEC) has not been established. We reviewed our experience in the management of patients with SCEC.

METHODS

The clinical data from 16 patients with SCEC were retrospectively collected with regard to demographics, use of tobacco or alcohol, presenting symptoms, tumor characteristics, staging, treatment, response, outcome, and survival.

RESULTS

Of the 16 patients, 4 of 8 patients with limited disease underwent curative resection followed by adjuvant chemotherapy. Three patients are still alive at 221, 75, and 34 months after treatment with no evidence of disease. The other 4 patients with limited disease received chemotherapy with or without surgery, and all died of disease within 21 months after treatment. The other 8 patients had extensive disease at presentation. One of these patients had chemotherapy followed by surgery. The prognosis for this group of patients was poor. The median survival of all patients was 13.5 months (range, 4 days to 221 months). The median survival of patients with limited disease was 20.5 months (range, 5 to 221), whereas it was 4.5 months for patients with extensive disease (range, 4 days to 44 months).

CONCLUSIONS

Small-cell carcinoma of the esophagus is a rare and highly malignant tumor with dismal prognosis. The treatment strategies for SCEC varied. Systemic chemotherapy should always be part of multimodality treatment. For patients with limited disease, curative resection followed by chemotherapy can provide long-term survival and can be considered as primary treatment for select patients.