基于单中心的原发性局限期食管小细胞癌根治手术临床疗效分析

The role of radical surgery in treatment of limited-stage primary small cell carcinoma of the esophagus based on clinical data of single center in China

目的:基于单中心临床资料分析原发性局限期食管小细胞癌根治性切除术的预后影响因素,探讨原发性局限期食管小细胞癌的有效诊疗模式。方法:回顾性分析海军军医大学附属长海医院胸外科2010年10月1日至2017年7月31日收治的30例原发性局限期食管小细胞癌患者的临床资料,分析治疗及随访结果,Cox回归模型分析患者预后影响因素。结果:30例食管小细胞癌患者术前胃镜病理诊断准确率为13.33%(4/30)。30例患者均顺利完成手术,治疗方式以根治性手术切除联合化疗为主,占80%(24/30);术后出现手术并发症3例,均予对症处理后顺利出院。患者术后1年、2年、3年生存率分别为54.8%、35.1%、26.4%。纵隔淋巴结转移是影响原发性局限期食管小细胞癌患者预后的危险因素。结论:局限期食管小细胞癌缺乏成熟有效的治疗模式,根治性手术切除联合化疗可改善其预后,但淋巴结转移患者可能无法从根治性切除手术中获益。

Objective:To investigate the clinical experience of radical surgery in treatment of limited-stage primary small cell carcinoma of the esophagus(PSCCE),and to optimize the treatment strategy of PSCCE.Methods:This retrospective study was designed to investigate the clinical characteristics of 30 PSCCE patients from October 1,2010 to July 31,2017 in Department of Thoracic Surgery,Changhai Hospital,Naval Military Medical University.The data of treatment and follow-up were analyzed in order to summarize the treatment experience.Results:The accuracy rate of preoperative gastroscopy pathological diagnosis was 13.33%(4/30),and 80%(24/30)was performed operation combined with chemotherapy.Three cases had postoperative complications,but all the patients were discharged successfully.The 1-,2-,and 3-year average overall survival rate of 30 patients were 54.8%,35.1%,and 26.4%,respectively.The multivariate analysis showed that lymph node metastasis was an independent prognostic factor for the patients with PSCCE.Conclusions:The choices of treatment for PSCCE remain uncertain,surgical resection combined with chemotherapy is effective for patients with PSCCE.The patients with lymph node metastasis may not benefit from radical surgery.