Clinical manifestation of esophageal carcinosarcoma: a Taiwan experience

Kuo, Chung-Huang; Lin, Ting-Yuan; Lin, Chih‐Lang; Wu, Ren Chin; Chang, Hsien‐Kun; Chu, Yen-Chang; Lien, Jau Min; Su, Ming‐Yao; Chiu, Chien-Hung

doi:10.1111/j.1442-2050.2009.00976.x

Cited by 29 publications

(29 citation statements)

References 23 publications

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“…In accordance with the previous reports, [1,11,19,20] most of the SpCC patients (67.6%) were in stage T1/2 at initial diagnosis, but only 29.7% for typical SCC were T1/2 ( P < 0.001), suggesting that SpCC was more likely to be diagnosed at an early stage. However, as reported, [1,11,19] no significant difference was found in harboring lymph node metastasis between both the groups even at stage T1/2 (41.7% vs 37.1%). This indicates that SpCC tends not to infiltrate deeply into the esophageal wall, but it presents a highly aggressive tendency of lymphatic spread even at the early T stage.…”

Section: Discussionsupporting

confidence: 92%

Spindle cell carcinoma of the esophagus

Zhang¹,

Xiao²,

Yang³

et al. 2016

Medicine

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This study conducted a retrospective multicenter analysis to investigate the clinicopathological features, optimal therapeutic strategy, and prognosis of spindle cell carcinoma (SpCC) of the esophagus.A total of 71 patients with esophageal SpCC from 3 large cancer centers in China were systematically analyzed. All patients received curative resection, 13 patients received adjuvant radiotherapy and 15 patients received adjuvant combination chemotherapy. Additionally, a total of 1852 patients with typical esophageal SCC (SCC) were selected as controls in this study.SpCC mostly presented as a polypoid appearance (66.2%), and the surrounding mucosa showed high-grade hyperplasia or superficial SCC in 31 cases (43.7%). Two patients even had extensive carcinoma in situ that spread to the resection margins. Patients in the SpCC group were more likely to present with stage I lesions compared with those in the typical SCC group (33.8% vs 8.0%, P < 0.001). Although the percentage of T1/2 lesions was higher in the SpCC group than in the typical SCC group (67.6% vs 29.7%, P < 0.001), both groups had similar rates of locoregional lymphatic metastases (45.1% vs 48.4%, P = 0.578). The median survival time and 5-year overall survival of the SpCC group was 43 months and 44.8%, respectively, higher than 37.5 months and 38.3%, respectively, for the typical SCC group (P = 0.044). In univariate analysis, the macroscopical type and pathological T, N, and TNM stages had a statistically significant impact on the prognosis of SpCC after curative resection. However, only the TNM stage (hazard ratio, 2.708; 95% confidence interval, 1.786–4.105, P < 0.001) was identified as an independent prognostic factor in multivariate analysis. The 5-year OS of SpCC in stages I (79.8%) and II (39.7%) were significantly longer than that of stages III/IV (16.2%) (P < 0.001 and P = 0.012). As those SpCC cases that received chemoradiotherapy were in more advanced stages, their prognosis was still worse than SpCC patients who did not receive chemoradiotherapy even after such treatment (P = 0.042, 0.010, respectively).SpCC shows a highly aggressive tendency of lymphatic spread, although it does not tend to infiltrate deeply into the esophageal wall. Compared with typical SCC that also underwent esophagectomy with extended lymphadenectomy, SpCC may achieve a better survival rate. Further investigation is warranted to examine the effect of postoperative chemoradiotherapy on the prognosis of SpCC.

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Section: Discussionsupporting

confidence: 92%

Spindle cell carcinoma of the esophagus

Zhang¹,

Xiao²,

Yang³

et al. 2016

Medicine

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“…6 In a study with Taiwanese patients, Kuo et al 7 reported that approximately 33% (4/12) of carcinosarcoma had previous head and neck squamous cell carcinoma that occurred metachronously. However, there has been no previous report on metachronous development of esophageal squamous cell carcinoma in a patient with carcinosarcoma.…”

Section: Discussionmentioning

confidence: 99%

A Case of Metachronous Development of Esophageal Squamous Cell Carcinoma in the Patient with Esophageal Carcinosarcoma

R.i.

Jung

et al. 2014

Korean J Gastroenterol

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Esophageal carcinosarcoma is a rare malignant esophageal neoplasm consisting of both carcinomatous and sarcomatous elements, with an incidence of 0.5%. There have been only a few case reports of carcinosarcoma and squamous cell carcinoma coexisting in the esophagus. However, all of these are cases of synchronous or metachronous development of carcinosarcoma after chemoradiotherapy in patients of esophageal squamous cell carcinoma. A 53-year-old man underwent esophagogastroduodenoscopy because of chest pain for several months. Endoscopic examination revealed a huge pedunculated esophageal polypoid mass. Endoscopic submucosal dissection (ESD) was performed and histopathologic examination confirmed spindle cell carcinoma (carcinosarcoma). He refused additional esophagectomy. After 21 months, third follow-up endoscopy showed poorly-demarcated flat, faint discolored lesions at different location from the previous ESD site and endoscopic biopsies confirmed squamous cell carcinoma. To the best of our knowledge, this is the first case of metachronous development of esophageal squamous cell carcinoma in a patient with esophageal carcinosarcoma. (Korean J Gastroenterol 2014;64:364-369)

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“…Otras entidades tales como melanoma maligno y sarcomas como histiocitoma maligno fibroso completan la lista de diagnósticos diferenciales 5,6,7,8,9 .…”

Section: Discussionunclassified

“…Para grandes lesiones puede considerarse la quimiorradioterapia preoperatoria. Se han descrito también casos de carcinosarcoma a nivel gástrico, tal como inicialmente fue planteado en el caso presentado en este artículo 6,9,11,14 .…”

Section: Discussionunclassified