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Annals of Oncology Advance Access originally published online on October 17, 2007
Annals of Oncology 2008 19(3):533-537; doi:10.1093/annonc/mdm476
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© The Author 2007. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org

gastrointestinal tumors

Small-cell carcinoma of the esophagus and gastroesophageal junction: review of the Memorial Sloan-Kettering experience

G. Y. Ku1, B. D. Minsky2, V. W. Rusch3, M. Bains3, D. P. Kelsen1 and D. H. Ilson1,*

1 Gastrointestinal Oncology Service, Department of Medicine
2 Thoracic Surgery Service, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY
3 Department of Radiation and Cellular Oncology, University of Chicago, Chicago, IL, USA

* Correspondence to: Dr D. H. Ilson, Department of Medicine, Gastrointestinal Oncology Service, Memorial Sloan-Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA. Tel: +1-212-639-8306; Fax: +1-212-717-3320; E-mail: ilsond{at}mskcc.org

Background: Esophageal small-cell carcinoma (SCC) is rare, highly malignant and the optimal treatment approach has not been defined.

Patients and methods: We report the largest single-institution retrospective review of patients with esophageal and gastroesophageal (GE) junction SCC.

Results: Twenty-five patients were identified, with complete records available for 22. Eighty-two percent were male, 82% had pure SCC histology and 86% of tumors were in the lower esophagus or GE junction. On the basis of the Veterans’ Administration Lung Study Group criteria, 14 patients (64%) presented with limited disease (LD). Median survival was 19.8 months (range, 1.5 months to 11.2+ years); for LD patients, 22.3 months (range, 6 months to 11.2+ years); for extensive disease (ED) patients, 8.5 months (range, 1.5 months to 2.2 years, P = 0.02). With a median follow-up of 38 months, six patients (27%) are alive, one with ED and five with LD. Two LD patients are alive and free of disease for >5 years. Four of the five LD patients who are long-term survivors received induction chemotherapy followed by chemoradiotherapy without surgery.

Conclusions: Our data indicate that patients with LD esophageal SCC treated with induction chemotherapy followed by consolidative chemoradiation can achieve long-term survival. The contribution of surgery remains unclear.

Key words: chemoradiotherapy, chemotherapy, esophagus, gastroesophageal junction, radiotherapy, small cell carcinoma, surgery

Received for publication September 4, 2007. Revision received September 6, 2007. Accepted for publication September 10, 2007.


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