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Okumura T, Fujii T, Terabayashi K, Kojima T, Takeda S, Kashiwada T, Toriyama K, Hijioka S, Miyazaki T, Yamamoto M, Tanabe S, Shirakawa Y, Furukawa M, Honma Y, Hoshino I, Nabeya Y, Yamaguchi H, Uemoto S, Shimada Y, Matsubara H, Ozawa S, Makuuchi H, Imamura M. MicroRNAs associated with postoperative outcomes in patients with limited stage neuroendocrine carcinoma of the esophagus. Oncol Lett 2023; 26:276. [PMID: 37274462 PMCID: PMC10236049 DOI: 10.3892/ol.2023.13862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 04/14/2023] [Indexed: 06/06/2023] Open
Abstract
Esophageal neuroendocrine carcinoma (E-NEC) is an aggressive disease with a poor prognosis. The present study aimed to assess the role of surgery in the treatment of patients with resectable E-NEC, and identify a microRNA (miRNA/miR) signature in association with positive postoperative outcomes. Between February 2017 and August 2019, 36 patients with E-NEC who underwent curative surgery at the Japan Neuroendocrine Tumor Society partner hospitals were enrolled in the study. A total of 16 (44.4%) patients achieved disease-free survival (non-relapse group), whereas 20 (55.6%) patients developed tumor relapse (relapse group) during the median follow-up time of 36.5 months (range, 1-242) after surgery with a 5-year overall survival rate of 100 and 10.8%, respectively (P<0.01). No clinicopathological parameters, such as histological type or TNM staging, were associated with tumor relapse. Microarray analysis of 2,630 miRNAs in 11 patients with sufficient quality RNA revealed 12 miRNAs (miR-1260a, -1260b, -1246, -4284, -612, -1249-3p, -296-5p, -575, -6805-3p, -12136, -6822-5p and -4454) that were differentially expressed between the relapse (n=6) and non-relapse (n=5) groups. Furthermore, the top three miRNAs (miR-1246, -1260a and -1260b) were associated with overall survival (P<0.01). These results demonstrated that surgery-based multidisciplinary treatment is effective in a distinct subpopulation of limited stage E-NEC. A specific miRNA gene set is suggested to be associated with treatment outcome.
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Affiliation(s)
- Tomoyuki Okumura
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 930-0194, Japan
| | - Tsutomu Fujii
- Department of Surgery and Science, Faculty of Medicine, Academic Assembly, University of Toyama, Toyama 930-0194, Japan
| | - Kenji Terabayashi
- Department of Mechanical and Intellectual Systems Engineering, Faculty of Engineering, University of Toyama, Toyama 930-8555, Japan
| | - Takashi Kojima
- Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, Kashiwa, Chiba 277-8577, Japan
| | - Shigeru Takeda
- Department of Gastroenterological, Breast and Endocrine Surgery, Graduate School of Medicine, Yamaguchi University, Ube, Yamaguchi 755-8505, Japan
| | - Tomomi Kashiwada
- Department of Medical Oncology, Division Hematology, Respiratory Medical and Oncology, Saga University, Saga 849-8501, Japan
| | - Kazuhiro Toriyama
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Susumu Hijioka
- Department of Gastroenterology, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan
| | - Tatsuya Miyazaki
- Department of General Surgical Science, Gunma University Graduate School of Medicine, Maebashi, Gunma 371-8511, Japan
| | - Miho Yamamoto
- Department of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan
| | - Shunsuke Tanabe
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Yasuhiro Shirakawa
- Department of Gastroenterological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama 700-8558, Japan
| | - Masayuki Furukawa
- Department of Hepato-Biliary-Pancreatology, National Hospital Organization Kyushu Cancer Center, Fukuoka 811-1395, Japan
| | - Yoshitaka Honma
- Department of Head and Neck, Esophageal Medical Oncology, National Cancer Center Hospital, Tokyo 104-0045, Japan
| | - Isamu Hoshino
- Division of Gastroenterological Surgery, Chiba Cancer Center, Chiba 260-8717, Japan
| | - Yoshihiro Nabeya
- Division of Gastroenterological Surgery, Chiba Cancer Center, Chiba 260-8717, Japan
| | - Hironori Yamaguchi
- Department of Clinical Oncology, Jichi Medical University, Shimotsuke, Tochigi 329-0498, Japan
| | - Shinji Uemoto
- President's Office, Shiga University of Medical Science, Otsu, Shiga 520-2192, Japan
| | - Yutaka Shimada
- Department of Nanobio Drug Discovery, Graduate School of Pharmaceutical Sciences, Kyoto University, Kyoto 606-8501, Japan
| | - Hisahiro Matsubara
- Department of Frontier Surgery, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
| | - Soji Ozawa
- Department of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan
| | - Hiroyasu Makuuchi
- Department of Gastroenterological Surgery, Tokai University School of Medicine, Isehara, Kanagawa 259-1193, Japan
| | - Masayuki Imamura
- Neuroendocrine Tumor Center, Kansai Electric Power Hospital, Osaka 553-0003, Japan
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Naimi A, Riahinezhad M. Primary esophageal small cell neuroendocrine carcinoma in a child: A case report with review on demography, presentation, treatment, and survival. Adv Biomed Res 2022; 11:95. [DOI: 10.4103/abr.abr_123_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2021] [Revised: 06/17/2021] [Accepted: 07/27/2021] [Indexed: 11/07/2022] Open
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Li Z, Hu J, Chen P, Zeng Z. Incidence, treatment, and survival analysis in esophageal neuroendocrine carcinoma population. Transl Cancer Res 2020; 9:4317-4329. [PMID: 35117798 PMCID: PMC8797452 DOI: 10.21037/tcr-19-2650] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2019] [Accepted: 05/29/2020] [Indexed: 12/26/2022]
Abstract
BACKGROUND As a subtype of esophageal neuroendocrine neoplasms (ENENs), esophageal neuroendocrine carcinoma (ENEC) is rare. ENEC can be poorly differentiated and highly aggressive. This study aims to illustrate the incidence, treatment, and prognosis of ENEC by using a population-based database. METHODS We collected clinicopathological data [1975-2016] of ENEC, esophageal adenocarcinoma (EACA), and esophageal squamous cell carcinoma (ESqCC) from the Surveillance, Epidemiology and End Results (SEER) database, and analyzed their incidence, treatment, and prognosis. RESULTS A total of 60,238 cases were in our study cohort, including ENEC (n=686), EACA (n=26,575), and ESqCC (n=32,977). The incidence of ENEC in 2016 was 0.044 per 100,000 persons. The tumor grade of ENEC was significantly higher than that of EACA and ESqCC (P<0.001). Both cancer-specific survival (CSS) and overall survival (OS) of ENEC were significantly worse than those of EACA and ESqCC (P<0.001). Kaplan-Meier analysis showed significant improvement of CSS and OS by surgery, radiotherapy, and chemotherapy (all P<0.001). Besides, compared with monotherapies, combinational therapies brought more benefits to both CSS and OS of patients with ENEC. CONCLUSIONS Our population-based evidence revealed that ENEC, as a rare cancer, had a worse prognosis, compared with EACA and ESqCC. Surgery, chemotherapy, and radiotherapy can all improve the prognosis of ENEC patients. Combinational therapy can yield a better prognosis than monotherapy.
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Affiliation(s)
- Zhenhua Li
- Department of Cardiothoracic Surgery, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, China
| | - Jiali Hu
- Department of Pathology, Jiujiang University Clinic College/Hospital, Jiujiang, China
| | - Pifeng Chen
- Department of Pediatric Surgery, Jiujiang Maternal and Child Health Hospital, Jiujiang, China
| | - Zhi Zeng
- Department of Pathology, Xianning Central Hospital, The First Affiliated Hospital of Hubei University of Science and Technology, Xianning, China
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Deng HY, Li G, Luo J, Li XR, Alai G, Lin YD. The Role of Surgery in Treating Resectable Limited Disease of Esophageal Neuroendocrine Carcinoma. World J Surg 2018; 42:2428-2436. [PMID: 29340724 DOI: 10.1007/s00268-018-4475-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Esophageal neuroendocrine carcinoma (NEC) is a rare malignant tumor. The role of surgery in resectable limited disease of esophageal NEC remains unclear. How to select a specific group of limited disease of esophageal NEC who might benefit from surgery remains to be answered. METHODS Patients undergoing esophagectomy for resectable limited disease of esophageal NEC in our department from January 2007 to June 2015 were analyzed. TNM staging system was applied to describe those patients, and according to their different long-term prognosis after surgery, those patients were subgrouped into surgery response limited disease (SRLD) group and surgery non-response limited disease (SNRLD) group. Both univariate and multivariate analyses were applied to identify potential prognostic factors. RESULTS A total of 72 patients with resectable limited disease of esophageal NEC were identified for analysis. The median survival time of those patients was 21.5 months. There was no significant survival differences among stage I, stage IIA, and stage IIB patients, but all these patients had significantly longer survival than stage III patients. Therefore, stage I, stage IIA, and stage IIB patients were aggregated together as SRLD group, and stage III patients were aggregated as SNRLD group. SRLD patients obtained significantly longer survival than SNRLD patients in both univariate analysis and multivariate analysis. Moreover, adjuvant therapy could significantly benefit SRLD patients (P = 0.004) but could not benefit SNRLD patients (P = 0.136). CONCLUSIONS Different responses to surgery existed in resectable limited disease of esophageal NEC indicating the need of further subgrouping for those patients. The resectable limited disease of esophageal NEC could be further subgrouped into SRLD group and SNRLD group according to the TNM staging system.
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Affiliation(s)
- Han-Yu Deng
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China.,Lung Cancer Center, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Gang Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Jun Luo
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Xin-Rui Li
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Guha Alai
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China
| | - Yi-Dan Lin
- Department of Thoracic Surgery, West China Hospital, Sichuan University, No. 37 Guoxue Alley, Chengdu, 610041, China.
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Gollard R, Ellis C, VanderHarten C. Small Cell/Neuroendocrine Tumors of the Esophagus: Presentation of Two Cases and Review of the Literature. TUMORI JOURNAL 2018; 96:780-3. [DOI: 10.1177/030089161009600524] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Small cell cancers of the gastrointestinal tract are part of a family of extrapulmonary small cell carcinomas. These tumors can occur anywhere in the body and generally carry a poor prognosis. Treatment usually consists of a combination of chemotherapy and radiation therapy. We present two cases illustrating diagnostic and treatment issues and review the literature on the treatment of this uncommon but aggressive family of tumors. Free full text available at www.tumorionline.it
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Affiliation(s)
- Russell Gollard
- Medical Oncology/Hematology, Cancer & Blood Specialists of Nevada, Henderson
| | - Carla Ellis
- Department of Pathology, Johns Hopkins University, Baltimore
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Deng HY, Ni PZ, Wang YC, Wang WP, Chen LQ. Neuroendocrine carcinoma of the esophagus: clinical characteristics and prognostic evaluation of 49 cases with surgical resection. J Thorac Dis 2016; 8:1250-6. [PMID: 27293844 DOI: 10.21037/jtd.2016.04.21] [Citation(s) in RCA: 46] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND The clinicopathological features and optimum treatment of esophageal neuroendocrine carcinoma (NEC) are hardly known due to its rarity. Therefore, we conducted a retrospective study to analyze the clinical characteristics and prognosis of patients with surgically resected esophageal NEC. METHODS We collected clinicopathological data on consecutive limited disease stage esophageal NEC patients who underwent esophagectomy with regional lymphadenectomy in West China Hospital from January 2007 to December 2013. RESULTS A total of forty-nine patients were analyzed retrospectively. The mean age of the patients was 58.4±8.2 years with male predominance. Fifty-five percent of the esophageal NEC were located in the middle thoracic esophagus. Histologically, 28 (57.1%) patients were found to be small cell NECs. Fifty-one percent of the patients were found to have lymph node metastasis. According to the 2009 American Joint Committee on Cancer (AJCC) staging system for esophageal squamous cell carcinoma, 9 patients were at stage I, 21 patients stage II, and 19 patients stage III. Twenty-six patients (53.1%) received adjuvant therapy. After a median follow-up of 44.8 months [95% confidence interval (CI), 35.2-50.4 months], the median survival time of the patients was 22.4 months (95% CI, 14.0-30.8 months). The 1-year and 3-year survival rates for the whole cohort patients were 74.9% and 35.3%, respectively. In univariate analysis, TNM staging, lymph node metastasis and adjutant therapy significantly influenced survival time. In multivariate analysis, TNM staging was the only independent prognostic factor. CONCLUSIONS Esophageal NEC has a poor prognosis. The 2009 AJCC TNM staging system for esophageal squamous cell carcinoma may also fit for esophageal NEC. Surgery combined with adjuvant therapy may be a good option for treating limited disease stage esophageal NEC. Further prospective studies defining the optimum therapeutic regimen for esophageal NEC are needed.
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Affiliation(s)
- Han-Yu Deng
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Peng-Zhi Ni
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Yun-Cang Wang
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Wen-Ping Wang
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, China
| | - Long-Qi Chen
- Department of Thoracic Surgery, West China Hospital of Sichuan University, Chengdu 610041, China
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Tao H, Li F, Wang J, Dong W, Gao J, Jiao S, Hu Y. Management of treatment-naïve limited-stage small cell esophagus carcinoma. Saudi Med J 2015; 36:297-303. [PMID: 25737171 PMCID: PMC4381013 DOI: 10.15537/smj.2015.3.11368] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Objectives: To identify the problems and principles of treatment decisions in treatment-naïve limited-stage small cell esophagus carcinoma (LD-SCEC). Methods: Clinical data from 39 patients with LD-SCEC treated in the Chinese People’s Liberation Army General Hospital, Beijing, China between 2000 and 2013 were retrospectively collected with regard to pathologic characteristics, overall survival (OS), and relevant prognostic factors. Results: The median OS was 21.1 months (95% confidence interval [CI]: 12.4-29.7 months). The one-year OS was 76%, 3-year was 25%, and the 5-year OS was 8%. Depth of invasion, lymph metastasis status, and chemotherapy were independent prognostic factors. Of the 39 cases, only 38.4% (15 cases) were diagnosed as SCEC by the biopsy specimen. Eight of the 15 patients (group A) received chemotherapy and/or radiotherapy, while the remaining 7 patients (group B) and the other 24 patients (group C) received surgery as initial treatment. The one-year survival of group A was 87%, of group B was 69%, and of group C was 74% (p=0.037). The accuracy of the biopsy diagnosis influenced the treatment decisions and prognosis. Conclusion: Small cell esophagus carcinoma is a systemic disease, with depth of invasion, lymph metastasis status, and chemotherapy as independent prognostic factors. Systemic therapy based on chemotherapy is recommended. The top priority is to improve the accuracy of diagnosis before deciding on the initial treatment option.
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Affiliation(s)
- Haitao Tao
- Department of Oncology, Chinese People's Liberation Army General Hospital, Beijing, China. E-mail.
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Feng JF, Zhao HG, Liu JS, Chen QX. Significance of preoperative C-reactive protein as a parameter in patients with small cell carcinoma of the esophagus. Onco Targets Ther 2013; 6:1147-51. [PMID: 24009425 PMCID: PMC3758215 DOI: 10.2147/ott.s50039] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Background C-reactive protein (CRP) is inversely related to prognosis in many cancers, however, no studies regarding the predictive value of CRP in small cell carcinoma of the esophagus (SCCE) are available. The aim of this study was to determine the prognostic value of preoperative CRP in patients with SCCE. Methods From January 2001 to December 2010, a retrospective analysis of 43 consecutive patients with SCCE was conducted. Univariate and multivariate analyses were performed to evaluate the prognostic parameters. Results In our study, elevated CRP levels (>10 mg/L) were found in 16 patients (37.2%). CRP levels were significantly higher in patients with deeply invasive tumors (P = 0.018) and those associated with nodal metastasis (P = 0.018). Patients with CRP ≤10 mg/L had a significantly better overall survival than patients with CRP >10 mg/L (25.9% vs 6.3%, P = 0.004). Multivariate analyses showed that CRP was a significant predictor for overall survival. CRP >10 mg/L had a hazard ratio of 2.756 (95% confidence interval: 1.115–6.813, P = 0.028) for overall survival. Conclusion Preoperative CRP is an independent predictive factor for long-term survival in patients with SCCE.
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Affiliation(s)
- Ji-Feng Feng
- Department of Thoracic Surgery, Zhejiang Cancer Hospital, Key Laboratory Diagnosis and Treatment Technology on Thoracic Oncology, Banshan Bridge, Hangzhou, People's Republic of China
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Hou X, Wei JC, Wu JX, Wang X, Fu JH, Lin P, Yang HX. Multidisciplinary modalities achieve encouraging long-term survival in resectable limited-disease esophageal small cell carcinoma. PLoS One 2013; 8:e69259. [PMID: 23874925 PMCID: PMC3706419 DOI: 10.1371/journal.pone.0069259] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2012] [Accepted: 06/11/2013] [Indexed: 12/29/2022] Open
Abstract
Background The management of limited-disease esophageal small cell carcinoma is not well defined, and the role of surgery is still controversial. We aim to determine the optimal treatment strategy in limited-disease of esophageal small cell carcinoma. Methods and Findings We conducted a retrospective review of 141 patients with limited-disease esophageal small cell carcinoma from 3 institutions in China who underwent treatment between July 1994 and September 2008, July 1994 and July 2011, and June 2004 and December 2010, respectively. The survival rate was calculated by the Kaplan-Meier method, and the log-rank test was used to assess the survival differences between the groups. Cox proportional hazards model were used to further determine the independent factors impacting overall survival. The median survival time was 16.1 months for the entire cohort of patients, with a 5-year survival rate of 6.7%. The median survival times for surgery alone, surgery combined with chemotherapy, surgery combined with radiotherapy, surgery combined with chemotherapy and radiotherapy, chemotherapy plus radiotherapy, and chemotherapy alone were 18.0 months, 15.0 months, 23.0 months, 25.0 months, 17.1 months, and 6.1 months, respectively; the corresponding 5-year survival rates were 0%, 15.4%, 0%, 38.9%, 0%, and 0%, respectively. For the 105 patients who underwent R0 resection, the median disease-free survival time was 12.0 months, with a 95% confidence interval of 9.5 months to 14.5 months. The multivariate Cox regression analysis demonstrated that advanced pathological staging (p = 0.003), and pure esophageal small cell carcinoma (p = 0.035) were independent factors decreasing overall survival. Conclusions Our data suggested that multidisciplinary modalities achieved encouraging long-term survival in patients with resectable limited-disease of esophageal small cell carcinoma.
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Affiliation(s)
- Xue Hou
- Department of Medical Oncology, Sun Yat-sen University Cancer Center, Guangzhou City, Guangdong Province, People’s Republic of China
- State Key Laboratory of Oncology in South China, Guangzhou City, Guangdong Province, People’s Republic of China
| | - Jin-Chang Wei
- Department of Thoracic Surgery, Linzhou Esophageal Cancer Hospital, Yaocun Town, Linzhou City, Henan Province, People’s Republic of China
| | - Jing-Xun Wu
- Department of Medical Oncology, the First Affiliated Hospital of Xiamen University; Xiamen City, Fujian Province, People’s Republic of China
| | - Xin Wang
- State Key Laboratory of Oncology in South China, Guangzhou City, Guangdong Province, People’s Republic of China
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center,Guangzhou City, Guangdong Province, People’s Republic of China
| | - Jian-Hua Fu
- State Key Laboratory of Oncology in South China, Guangzhou City, Guangdong Province, People’s Republic of China
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center,Guangzhou City, Guangdong Province, People’s Republic of China
| | - Peng Lin
- State Key Laboratory of Oncology in South China, Guangzhou City, Guangdong Province, People’s Republic of China
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center,Guangzhou City, Guangdong Province, People’s Republic of China
| | - Hao-Xian Yang
- State Key Laboratory of Oncology in South China, Guangzhou City, Guangdong Province, People’s Republic of China
- Department of Thoracic Surgery, Sun Yat-sen University Cancer Center,Guangzhou City, Guangdong Province, People’s Republic of China
- * E-mail:
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Surgical Treatment for Limited-Stage Primary Small Cell Cancer of the Esophagus. Ann Thorac Surg 2013; 95:1057-62. [DOI: 10.1016/j.athoracsur.2012.11.014] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2012] [Revised: 11/04/2012] [Accepted: 11/06/2012] [Indexed: 02/07/2023]
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Radiotherapy and chemotherapy are associated with improved outcomes over surgery and chemotherapy in the management of limited-stage small cell esophageal carcinoma. Radiother Oncol 2013; 106:317-22. [DOI: 10.1016/j.radonc.2013.01.008] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Revised: 01/20/2013] [Accepted: 01/27/2013] [Indexed: 01/30/2023]
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