食管小细胞未分化癌75例临床分析

目的探讨食管小细胞未分化癌的临床特点、治疗及预后。方法对75例食管小细胞未分化癌患者进行回顾性分析。男性58例，女性17例。食管颈段2例，胸上段11例，胸中段46例，胸下段16例。37例肿瘤长度≤5cm，38例＞5cm。单纯手术16例(21.3%)，单纯化疗5例(6.7%)，单纯放射治疗4例(5.3%)，手术+化疗32例(42.6%)，化疗+放射治疗14例(18.0%)，手术+化疗+放射治疗4例(5.3%)。结果单纯手术者、单纯化疗者、单纯放射治疗者、综合治疗者的中位生存时间分别为13、8、7、11个月，全组的中位生存期为8个月，生存最长者已达127个月。1、2、3、4、5年生存率分别为42.5%、15.5%、12.9%、11.1%、10.9%。结论病变长度是影响预后因素之一。对于食管小细胞未分化癌，应采用综合治疗。手术+化疗对早期病例可能提高远期疗效。

Undifferentiated small cell esophageal car cinoma in 75 patients

Objective To investigate the clinical characteristics, treatment and prognosis of undifferentiated small cell esophageal carcinoma (SCEC). Methods From 1984 to 1999, 75 patients with SCEC were treated. There are 58 male and 17 female. The primary tumor was located in the cervical esophagus in 2 patients, upper thoracic in 11, mid thoracic in 46, and lower in 16. Twenty-five patients were treated with surgery alone, radiotherapy alone, or chemotherapy alone. The remaining 50 patients were treated with combined modality.Results The median of survivals was 8 months for all patients, with 13 months for surgery, 8 months for radiotherapy, 7 for chemotherapy and 11 for combined modality treatment. The survival rates at 1, 2, 3, 4, and 5 years were 42.5%, 15.5%, 12.9%, 11.1%, and 10.9%, respectively. Conclusions The length of primary tumor is a prognostic factor. We suggest combined modality for SCEC. Surgery plus multi-drug chemotherapy may improve the treatment results.