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International Journal of Clinical Oncology

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01-05-2020 | Metastasis | Original Article

Treatment strategies for neuroendocrine carcinoma of the upper digestive tract

Authors: Masaru Morita, Kenichi Taguchi, Masaki Kagawa, Tomonori Nakanoko, Hideo Uehara, Masahiko Sugiyama, Mitsuhiko Ota, Masahiko Ikebe, Keishi Sugimachi, Taito Esaki, Yasushi Toh

Published in: International Journal of Clinical Oncology | Issue 5/2020

Abstract

Background

Neuroendocrine carcinoma (NEC) of the esophagus and the stomach is aggressive. The purpose of this study was to determine the optimal therapeutic strategy.

Methods

Both clinicopathological factors and treatment results were examined in 34 patients with immunohistochemically diagnosed NEC of the upper gastrointestinal tract (esophagus 22; stomach 12).

Results

Twenty-nine tumors showed protruding and localized type, like submucosal tumor. Esophagectomy and gastrectomy were performed in six and eight patients, respectively. Among the six patients with esophageal NEC, three with node metastasis developed recurrence within seven months, while the other three (pT1bN0) had no recurrence. Regarding gastric NEC, three patients with pT3N1 or 2 tumor received adjuvant chemotherapy and achieved a 5-year survival. However, the other five experienced recurrence after gastrectomy. Systemic chemotherapy was performed as the main treatment for 18 patients with advanced NEC. The median survival was 10 months after initial chemotherapy. No marked differences in the response were recognized between the 14 cases with esophageal NEC and the 4 with gastric NEC. The median survival was 14.3 and 5.3 months for the 11 effective and 7 non-effective patients, respectively.

Conclusions

A macroscopically unique appearance, like submucosal tumor, suggests the possibility of NEC. Esophagectomy is an effective treatment option for limited-stage NEC without node metastasis, while gastrectomy followed by adjuvant chemotherapy may be effective for NEC even with node metastasis when R0 resection can be achieved. Systemic chemotherapy is relatively effective for advanced NEC, although early progression frequently develops.

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Title: Treatment strategies for neuroendocrine carcinoma of the upper digestive tract
Authors: Masaru Morita
Kenichi Taguchi
Masaki Kagawa
Tomonori Nakanoko
Hideo Uehara
Masahiko Sugiyama
Mitsuhiko Ota
Masahiko Ikebe
Keishi Sugimachi
Taito Esaki
Yasushi Toh
Publication date: 01-05-2020
Publisher: Springer Singapore
Keywords: Metastasis
Esophagus Resection
Gastrectomy
Esophagus Resection
Gastrectomy
Cytostatic Therapy
Published in: International Journal of Clinical Oncology / Issue 5/2020
Print ISSN: 1341-9625
Electronic ISSN: 1437-7772
DOI: https://doi.org/10.1007/s10147-020-01631-y

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Abstract

Background

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