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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.

Clinical factors and molecular markers can be used to predict the prognosis of gefitinib-treated locally advanced or metastatic non-small cell lung cancer (NSCLC). This study was to identify predictive factors for the response and survival of gefitinib-treated locally advanced or metastatic NSCLC patients in China.Clinical data of 256 gefitinib-treated Chinese NSCLC patients from two existing clinical trials were analyzed. Univariate and multivariate analyses were performed to determine predictive factors of response and survival.The objective response rate was 24.6%; the disease control rate was 54.7%. Median survival time was 11.43 months (95% CI, 8.64-14.22 months). The 1-year survival rate was 48.0% (95% CI, 41.0%-55.0%). Adenocarcinoma and skin rash were associated with better response. The patients with lower performance status (PS) score (0-1) and those with disease control (complete remission, partial remission, and stable disease) had longer survival when compared with their counterparts.Adenocarcinoma and skin rash are predictors of better response to gefitinib. Low PS score and disease control are predictors of longer survival after treatment of gefitinib.