Clinical characteristics of adenosquamous esophageal carcinoma

Yendamuri, Sai; Malhotra, Usha; Hennon, Mark; Miller, Austin; Groman, Adrienne; Halloon, Alaa; Reid, Mary E.

doi:10.21037/jgo.2016.12.03

Cited by 28 publications

(50 citation statements)

References 15 publications

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“…Patients with ASC had worse OS compared to ACA, but not ESCC in both univariate and multivariate analyses (OR=0.76; Scale bar, A, B, E, F, 500 μm, C, D, G, H, 100 FOXA1 expression and patients' overall survival. For A, age<61 years old, B, middle esophagus, C, non-lymph node metastasis. p<0.05 and OR=0.86; p<0.05 respectively) [27]. GECEC had no glands compared to ASC, but had worse OS compared to ESCC patients, suggesting that GECEC may be a subtype of esophageal cancer with poor prognosis.…”

Section: Discussionmentioning

confidence: 87%

“…The functions and meanings of the GECEC are not clear. Adenosquamous esophageal carcinoma (ACS) is another esophageal cancer subtype, a rare histological variant comprising 1% of esophageal adenocarcinoma (ACA) in the Unites States [27]. Patients with ASC had worse OS compared to ACA, but not ESCC in both univariate and multivariate analyses (OR=0.76; Scale bar, A, B, E, F, 500 μm, C, D, G, H, 100 FOXA1 expression and patients' overall survival.…”

Section: Discussionmentioning

confidence: 99%

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FOXA1 and CK7 expression in esophageal squamous cell carcinoma and its prognostic significance

Xu¹,

Wang²,

Li³

et al. 2018

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Esophageal Squamous Cell Carcinoma (ESCC) is one of the most common malignant tumors in human. Some ESCC cells express adenocarcinoma cell markers, such as Cytokeratin 7 (CK7), but the clinical significance of these cells in ESCC is unknown. Immunohistochemical analysis of CK7 and Fork head box protein A1(FOXA1, an upstream regulator of CK7) was performed on 610 ESCC specimens using tissue microarray. In total, positive staining of CK7 was 59/594 (10%). CK7 expression was correlated with ESCC differentiation (P=0.006). The expression of CK7 is associated with poor overall survival (OS) of ESCC patients (P=0.0498). FOXA1 positive staining was 180/586(31%). FOXA1 expression correlates with differentiation (P<0.0001) and vascular invasion status (P=0.016) of ESCC. FOXA1 expression was non-independently correlated with poor prognosis of OS in ESCC patients (P=0.1198), but correlated with the prognosis of ESCC patients in some specific pathological characteristics, such as age less than 61 years (P=0.0066), tumor located in the middle segment of esophagus (P=0.0046), and non-lymph node metastasis (P=0.0377). Correlation analysis between the CK7 and FOXA1 expression was positive (P<0.0001). In conclusion, FOXA1 expression was positive correlated with CK7 expression. CK7 expression is an independent prognostic factor for ESCC, and FOXA1 is a non-independent prognostic factor. CK7 and its upstream factor FOXA1 both can be used as potential targets for ESCC therapy.

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Section: Discussionmentioning

confidence: 87%

Section: Discussionmentioning

confidence: 99%

FOXA1 and CK7 expression in esophageal squamous cell carcinoma and its prognostic significance

Xu¹,

Wang²,

Li³

et al. 2018

neo

View full text Add to dashboard Cite

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“…In patient series from both Asia[ 3 , 4 , 5 , 6 , 7 ] and the US,[ 8 , 9 ] the reported incidence rates range between 0.37%[5] and 1%. [ 3 , 7 , 9 ] The age and gender distribution is also consistent throughout the literature. ASC mostly presents in people older than 40 years, with incidence peaking around the 7th decade of life.…”

Section: Epidemiologymentioning

confidence: 99%

“…Studies have shown dysphagia to be the most common presenting symptom of ASC, followed by retrosternal or upper abdominal pain and weight loss. [ 3 , 5 , 6 , 9 , 25 ]…”

Section: Clinical Presentationmentioning

confidence: 99%

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Adenosquamous carcinoma of the esophagus: A literature review

Schizas

Kapsampelis

Mylonas³

2018

Journal of Translational Internal Medicine

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Adenosquamous carcinoma (ASC) of the esophagus is an uncommon type of esophageal cancer that contains both adenocarcinoma and squamous cell carcinoma elements. Data on this biologically unique type of cancer are limited and mainly stem from case reports and small case series. We performed an audit of the available literature and synthesized a review on the epidemiology, pathogenesis, histopathology, clinical manifestations, diagnosis, treatment and prognosis of ASCs. Adenosquamous carcinoma of the esophagus is a rare type of esophageal cancer. Histological examination is necessary to confirm the diagnosis of ASC and patients usually receive multimodal treatment. Patient outcomes are not well defined and further research could help us better understand the pathophysiology and unique needs of patients with this rare malignancy.

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Should adenosquamous esophageal cancer be treated like adenocarcinoma or squamous cell carcinoma?

Gamboa

Meyer

Switchenko

et al. 2020

Journal of Surgical Oncology

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Background Esophageal adenocarcinoma (AC) and squamous cell carcinoma (SCC) have distinct outcomes, treatment strategies, and response profiles to therapy. Adenosquamous carcinoma (ASC) is thought to behave more aggressively than each of its counterparts. The aim of this study is to determine ifASC is best managed as AC or SCC. Methods National Cancer Database (2004‐2015) was queried for patients with nonmetastatic esophageal ASC. The analysis was stratified by clinical node‐negative (cN0) or clinical node‐positive (cN1‐3). Treatment was categorized into chemoradiation alone, surgery alone, or preoperative chemoradiation followed by surgery. The primary outcome was 5‐year overall survival (OS). Results Among 352 patients, 43% were cN0 (n = 151), 57% were cN1‐3 (n = 201) and 55% had chemoradiation alone (n = 194), 15% surgery alone (n = 53), and 30% preoperative chemoradiation (n = 105). Among patients who had preoperative chemoradiation, 20% had pathologic complete response (n = 17). For either cN0 or cN1‐3, Charlson‐Deyo Comorbidity Index did not differ among the treatment groups(all p > 0.05). On Kaplan‐Meier analysis for cN0, treatment with surgery alone had comparable OS to preoperative chemoradiation (47% vs 34%; P = .5) and each had improved OS compared to chemoradiation alone (30%; P = .02; P = .06). On univariate analysis for cN0, clinical T category was not associated with OS. For cN1‐3, however, preoperative chemoradiation was associated with improved OS when compared to chemoradiation alone or surgery alone (27% vs 19% vs 0%; P < .001). This persisted when accounting for age and clinical T category (hazard ratio: 0.45; P < .001). Conclusion Esophageal ASC behaves more like AC in response to chemoradiation and survival based on treatment modality. A complete response to chemoradiation is only 20% unlike what has been shown for SCC, where chemoradiation is an acceptable definitive therapy. Esophageal ASC should be managed more like AC.

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Clinical characteristics of adenosquamous esophageal carcinoma

Cited by 28 publications

References 15 publications

FOXA1 and CK7 expression in esophageal squamous cell carcinoma and its prognostic significance

FOXA1 and CK7 expression in esophageal squamous cell carcinoma and its prognostic significance

Adenosquamous carcinoma of the esophagus: A literature review

Should adenosquamous esophageal cancer be treated like adenocarcinoma or squamous cell carcinoma?

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