Analysis Of Clinical And Pathological Features And Curative Effect Of Primary Small Cell Carcinoma Of The Esophagus

Purpose:This study aims to analyze the clinical features of patients with primary small cell carcinoma of the esophagus(SCEC),compare the efficacy of different treatment options,explore the factors that affect the prognosis of patients with SCEC,and provide reference for the treatment decision-making of patients with SCEC.Method:The SCEC patients who were treated at the Shandong Cancer Hospital from January 2008 to May 2017 are retrospectively included.After searching the medical record system,the clinical features of the patient are collected.By telephone follow-up,etc.,to obtain the time of disease progression and the time of death.Follow-up end in October 2017.Survival analysis is performed using the Kaplan-Meier method.Log-Rank is used to compare the survival curves of different factors.When the single factor is statistically significant,Cox regression model is used to analyze the factors affecting overall survival.Result:A total of 95 patients with SCEC are included in this study,including 75 males and 20 females.The ratio of males and females is 3.75:1.The average age of onset is 62.43(41-82 years).The first symptom is dysphagia(75.8%).The lesions are located in the middle(54.7%)and the lower(34.7%),and the average lesion length is 5.55cm(1-13cm).By the time of follow-up,55 were dead,30 survived,and 10 were lost.The median follow-up time was 12.3 months(0.8-60 months),the median OS was 14.9 months(0.8-60 months),and the median PFS was 9.1 months(0.8-60 months).Of the 85 patients,2 were given up for treatment,and 83 patients received treatment.The median OS is 8.8 months in the surgery alone group,11.2 months in the chemotherapy alone group,and 12.1 months in the radiotherapy alone group.the median OS in the surgery plus chemotherapy group is 14.9months,the median OS in the radiochemotherapy group is 34.1 months,and the median time in the surgery plus radiochemotherapy group was not reached(1,2,3,and 5-year survival rates were 100.0%,80.0%,53.3%,53.3%,respectively.).Among them,the surgery plus radiochemotherapy group had the longest survival time,which is significantly higher than that of the surgery alone group,the chemotherapy alone group,and the radiotherapy alone group(P<0.001),but it is not significantly different from the radiotherapy and chemotherapy group(P=0.200).Kaplan-Meier univariate survival analysis show that TNM staging,VALSG staging,lesion length and treatments have significant effects on OS and PFS in SCEC patients(P<0.05).Chemotherapy cycles have a significant effect on OS in SCEC patients.P=0.044)without significant effect on PFS(P=0.147).Multivariate analysis show that lesion length(P=0.003)and treatments(P=0.004)are independent predictors of prognosis in SCEC patients.Conclusion:The incidence of SCEC is extremely low.Currently there is no standard treatment model.This study shows that the comprehensive treatment has a better effect on OS and PFS than the single treatment.For LD patients,it is recommended to use chemotherapy as the basis for joint surgery or radiotherapy and other local treatment methods.In general,LD patients who are not able to tolerate surgery and ED patients should be treated with a combination of radiotherapy and chemotherapy.