PS02.199: STRATEGY FOR TREATMENT OF NEUROENDOCRINE TUMORS OF THE ESOPHAGUS

Abstract Background Neuroendocrine tumors of the esophagus are very rare. The prognosis is known to be poor, and there is no consensus on treatment strategy. Methods We investigated 27 patients who underwent surgery for neuroendocrine tumor of the esophagus at our institute between 1968 and 2017. We researched (1) Background, (2) Treatment, (3) Types of the recurrences, and (4) Prognosis. Results (1) Male: female = 22: 5, Median age; 64.2 (24–77), Location; Ut: Mt: Lt: Ae = 1: 15: 9: 2, Depth of the tumors: T1: T2: T3: T4 = 9: 3: 11: 4, Median length of the tumors; 57.7 mm (14–130), Pathological types; pure type: mixed type = 10:17, Lymph node metastasis; N0: N(+ ) = 3: 24. (2) Surgical approach; right thoracotomy:left thoracoabdominal incision:transhiatal approach = 24: 2: 1, Organ used for reconstruction; stomach: colon = 25: 2, Route of reconstruction; antethoracic: retrosternal: posterior mediastinal = 10: 5: 12, Neoadjuvant therapy; (+ ): (-) = 15: 12. (3) Types of recurrences; liver: lung: lymph nodes: bone: dissemination = 7: 6: 4: 2: 4. (4) Median survival time was 10 months (1–98). Compared by (a) tumor depth, (b) number of metastatic LNs, (c)with or without adjuvant therapy were as follows; (a) T1: T2–4 = 19: 5 months (P = 0.0202), (b) 0–2: > 2 = 19: 4 months (P < 0.001), (c) (+ ): (-) = 12: 5 months(P = 0.141). Conclusion Approximately 2/3 cases were accompanied with poorly differentiated SCC, and most of those cases were diagnosed as NET after surgery. Prognosis is poor, but pT1 cases and cases with small number of LN metastases showed better prognosis. Although without significant difference, cases with adjuvant therapy showed longer prognosis. Our opinion is, if with selection of cases and strong adjuvant therapy, surgery can be a feasible choice. Disclosure All authors have declared no conflicts of interest.