Poorer prognosis in patients with advanced gastric squamous cell carcinoma compared with adenocarcinoma of the stomach

Abstract

Rationale:Primary squamous cell carcinoma (SCC) of the stomach is a rare disease. The pathogenesis and prognosis of advanced SCC remains to be elucidated. The aim of the current study was to investigate the prognosis of recurrent or metastatic SCC of the stomach.Patient concerns:A retrospective study examined the clinical characteristics and survival outcomes of 14 patients diagnosed with recurrent or metastatic SCC of the stomach, including 7 patients followed up in the hospital and 7 patients selected from the PubMed and Chinese National Knowledge Infrastructure (CNKI) database with meta-analysis between January 2003 and January 2016.Diagnoses:All patients meet the following diagnoses criteria: histological diagnosis of gastric squamous cell carcinoma; the tumor must not be located in the cardia area or extend into the esophagus; presence of local relapse or distant metastases of gastric SCC in computed tomography (CT) images; and no evidence of secondary SCC in the body. Clinical pathological data and follow-up data were obtained from the medical record or case report of each patient.Interventions:Palliative chemotherapy was administered in 14 patients diagnosed with recurrent or metastatic gastric SCC.Outcomes:The median age of 14 patients (10 males and 4 females) was 61 years old (range, 28–76). In total, 57% (8/14 cases) of tumors were located on the lesser curvature side of the stomach and 64% (9/14 cases) of metastatic sites were identified in the liver. All patients received systemic chemotherapy, and their median survival was 7.0 months (range, 2.0–22.3 months).Lessons:The median survival of patients with advanced gastric SCC was shorter than the median survival (11 months) of advanced gastric adenocarcinoma, suggesting that advanced gastric SCC may have a poorer prognosis compared with adenocarcinoma of the stomach in recurrent or metastatic stage.

Exophytic primary gastric squamous cell carcinoma andH. pylorigastritis

“…Unfortunately, because of its advanced stage upon diagnosis, the majority of the patients are not surgical candidate; various palliative chemo regimens including fluoropyrimidine-based, platin-based and taxane-based combined chemotherapy have been reported. With these chemotherapies, primary gastric SCC has an overall survival ranging from 2 to 22 months (median 7 months) in the previous reports, usually longer in patients who had surgery with a progression-free survival of 10 months from the date of surgery to recurrence or metastasis 13. In two case reports with concurrent chemoradiotherapy, the overall survival was actually increased to 27 months17 and 60 months 18.…”

“…Because of its rarity, understandings of primary gastric SCC are mainly based on case reports and case series studies 13. Gastric SCC predominantly affects male patients with an age of around 60,13 14 and abdominal pain and weight loss are the two most common symptoms. The most common location of the tumour is lesser curvature, followed by greater curvature.…”

“…Surgical excision may improve the prognosis and remains the only potential cure for primary gastric SCC 13. Unfortunately, because of its advanced stage upon diagnosis, the majority of the patients are not surgical candidate; various palliative chemo regimens including fluoropyrimidine-based, platin-based and taxane-based combined chemotherapy have been reported.…”

Primary Gastric Squamous Cell Carcinoma

“…Other alternatives used are platin and taxane-based regimens. These include docetaxel + oxaliplatin/cisplatin + fluorouracil (DOF), fluorouracil + oxaliplatin + calcium folinate (FOLFOX), capecitabine + oxaliplatin (XELOX), docetaxel + capecitabine, cisplatin + fluorouracil/campitabine/S-1, docetaxel + cisplatin/oxaliplatin (TP), gemcitabine + fluorouracil (GF) and pirabucin + fluorouracil [ 10 ]. It is important to mention that some reports have found neoadjuvant chemotherapy for PGSCC to be effective [ 4 ]; however, there is no definitive role according to the available data [ 8 ].…”

“…A new retrospective study published by Meng et al showed a poorer prognosis in patients with advanced gastric SCC, compared with adenocarcinoma of the stomach, with a median survival of seven months [ 10 ]. This is due to the advanced stage at the time of diagnosis [ 8 - 9 ].…”