ABSTRACT
A 79-year-old man presented to our hospital with 1-month history of discomfort on swallowing and pain in the thoracodorsal region. Image investigation revealed a tumor lesion affecting the area from the lower esophagus to the gastric antrum, and small cell carcinoma of esophagus was diagnosed based on biopsy. He was treated with resection of the lower esophagus and the upper part of the stomach and a postoperative chemoradiotherapy. The patient follow-upwas without recurrence until a malignant lymphoma developed 4 years and 5 months after the surgery. Chemotherapy was provided for the malignant lymphoma, however, the patient died 6 years and 4 months after the surgery for small cell carcinoma of esophagus. Small cell endocrine carcinoma of the esophagus is a relatively rare disease and its prognosis is poor. In our patient, long-term survival was achieved with multimodal treatment, however malignant lymphoma developed during the follow-upp eriod. This is the second case of metachronous cancer after the treatment for small cell carcinoma of the esophagus in Japan, and it is considered to be extremely rare.
Subject(s)
Carcinoma, Small Cell , Esophageal Neoplasms , Aged , Combined Modality Therapy , Humans , Japan , Male , Neoplasm Recurrence, LocalABSTRACT
BACKGROUND/AIMS: The aim of this study was to identify the factors influencing mortality, morbidity and survival for gastric cancer in patients 80 years of age and older. METHODOLOGY: This retrospective study of gastric cancer in the elderly was conducted from 2003 to 2008. We examined demographic data, treatment, causes of death and their overall survival. RESULTS: On gastric cancer in the elderly, the stage IV was significantly higher in non-surgery group (47%) than in surgery group (12%). Moreover, non-surgery group had significantly more cardiac disease (p = 0.007) and previous stroke (p = 0.035) than surgery group. Differences in overall survival were statistically significant among stage I (p = 0.025) and stage II/III (p <0.001) patients. The other, the overall survival difference was not statistically significant between surgery group and non-surgery group, in stage IV (p = 0.05). CONCLUSIONS: In the study, age is not the only contraindication to resection for gastric cancer because when elderly patients undergo curative resection, they do not have a worse prognosis than without surgery group. In the elderly, the surgical strategy must be always modulated on the basis of preoperative comorbidities, the degree of the tumor spread, and the expected equality of life offered by a surgical procedure.
