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Background and Objective: Esophageal small cell carcinoma (Small-cell carcinoma of the esophagus) is a highly aggressive and lethal malignancy, clinically relatively rare, since 1952 Mckeown first reported since its only about 250 cases documented. As rare cases, small cell carcinoma of the esophagus aspects concerning the medical records is very limited. Given the lack of relevant information and have been more familiar with small cell lung cancer similarity, small cell carcinoma of the esophagus at the disposal of the latter treatment is usually handled. However, in recent years about the esophageal small cell carcinoma and small cell lung cancer in a similar manner of disposal has been questioned. In order to more clearly esophageal small cell carcinoma of the clinical features and a variety of treatment modalities of treatment effect and impact, we did a study for the January 1995-December 2007 between the Tang Du Hospital, surgical treatment of thoracic esophageal small cell cancer patients were retrospectively analyzed relevant data. METHODS: All diagnosis of esophageal small cell carcinoma patients are clinically and pathologically confirmed information. Clinical data, imaging and pathological results were retrospectively analyzed, those who can not clear whether the involvement of primary esophageal small cell bronchial carcinoma cases were caused by excluded from the study. The clinical data showed that a total of 31 patients in the last 12 years was diagnosed with small cell carcinoma of the esophagus and make the relevant treatment. Review data in a detailed record of the relevant data, clinical symptoms, diagnosis, clinical staging, treatment, pathology results and treatment outcomes. Review of relevant tissue sections also OK to assessments esophageal small cell carcinoma. Accompanied by tumor characteristics, type of tissue differentiation and lymph node metastasis is specifically calibrated for the differential diagnosis of immunohistochemistry. Results: The study group included 31 consecutive patients cases, including 22 males and 9 females, mean age 58 years (45 years old -76 years old). All cases were reported in patients starting treatment when symptoms of dysphagia, weight loss and (or) chest pain. Barium meal, esophageal endoscopy and biopsy pathology supported the diagnosis. Chest imaging performance without primary lung cancer before surgery underwent liver ultrasound examination to rule out liver metastasis situation. Esophageal cancer in 13 cases, 16 cases of the lower esophagus, the upper esophagus in 2 cases. The average tumor length 5cm. 27 patients received chemotherapy, partial resection of the esophagus, esophageal - gastric intrathoracic anastomosis or neck anastomosis, lymph node dissection. According to exploratory surgery and pathology evaluation, referring to UICC criteria: 27 patients, 2 cases of stage I and 10 patients were stage IIa, IIb period of nine patients, 6 patients with stage Ⅲ. The remaining four cases of stage Ⅳ patients received only chemotherapy. Radiation therapy is not statistics. World Health Organization recommended the organization of small-cell lung cancer evaluation criteria used here to refer to evaluate the performance of small-cell esophageal cancer tissues. Neuron-specific enolase (NSE), synaptophysin (Syn) and chromogranin A immunohistochemical staining in reacting strongly neuroendocrine tumor samples showed high levels of particles. 7 cases of squamous cell carcinoma specimens containing ingredients. 19 patients found that the performance of adjacent lymph node metastasis. 31 patients, the median survival time was 10 months. After 1 year, 2 years and 3-year survival rates were 45.1%, 16.1%, 6.4%. Clinical stage, surgery and chemotherapy is an important prognostic factor. Surgery postoperative chemotherapy group, the median survival time was 12 months. After 1 year, 2 years and 3-year survival rates were 70%, 35.2%, 11%; surgery group 10 cases, 8 cases died within 1 year (62.1%), 1-year survival rate was 20%, no one patients survived more than two years. Without lymph node metastasis in patients undergoing surgery after chemotherapy, the median survival time was 13 months. After 1 year, 2 years and 3-year survival rates were 75%, 33.3%, 16.6%; lymph node metastasis in patients with postoperative 5-year survival was 26.3%, 5.2%, 0.0%; Conclusion: esophageal small cell carcinoma is a rare malignant tumor, the prognosis is poor. During treatment with chemotherapy dominant, but it should also attach importance to the role of surgery, surgery can be more early cases supplemented by significant improvements in survival time of patients.
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