Small cell carcinoma of the esophagus - The University of Texas M, D. Anderson Cancer Center experience and literature review

BACKGROUND, Small cell carcinoma of the esophagus is a rare disease with ag gressive behavior and poor prognosis. Multidrug chemotherapy remains the tr eatment of choice given the systemic nature of the disease. Radiotherapy ha s been used concurrently with chemotherapy to enhance local control. The ro le of surgery in patients with limited disease is controversial Limited dat a exist regarding the pathologic response of die tumor to chemoradiotherapy , The goal of the current study was to analyze the outcome of 8 patients tr eated at the M. D. Anderson Cancer Center, with particular focus on the his tologic findings of the resected specimens. METHODS. Patient records were reviewed for demographics, presenting symptom s, diagnostic modalities, disease stage, treatment, and outcome. RESULTS, Two of eight patients had metastatic disease at the time of diagno sis and received combination chemotherapy. Six patients had limited stage d isease. Four received combined modality treatment including esophagectomy, and two received radiotherapy only. AU four patients who underwent esophage ctomy had pure small cell carcinoma histology at diagnosis and received pre operative combination chemotherapy with-or without radiotherapy None of the four patients achieved a pathologic complete remission. Two patients had r esidual small cell carcinoma; one patient had squamous cell carcinoma and n e adenocarcinoma. The median overall survival for the group of patients was 12.5 months (range, 5-57 months). CONCLUSIONS In selected patients with limited stage disease, surgery with c urative intent should be considered as part of multimodality treatment. (C) 2000 American Cancer Society.