Surgical resection for esophageal adenosquamous carcinoma: an analysis of 56 cases

Abstract

Background Esophageal adenosquamous carcinoma (EASC) is a rare disease. The biological behavior and treatment of this malignancy are not well studied. Methods Data from 56 patients with EASC who underwent esophagectomy were retrospectively analyzed and compared with 5028 patients with esophageal squamous cell carcinoma (ESCC). The impact of clinicopathological factors on the survival of patients with EASC was analyzed. The survival differences between patients with EASC and ESCC were also compared. Results There were 43 males and 13 females with a mean age of 59.7 ± 1.3 years (range, 39–79 years). Only 1 of the 43 patients who received preoperative esophagoscopic biopsy was diagnosed with EASC. The median survival time for patients with EASC was 32.0 months, and the 1-, 3-, and 5-year overall survival rates were 78.3%, 46.1%, and 29.6%, respectively. Resection margin, pN category, and adjuvant chemotherapy were found to be independent predictors. After 1:1 propensity score matching, the 5-year overall survival rate of 29.6% for patients with EASC was similar to that of 42.5% for patients with ESCC (P = 0.179). Conclusions EASC is a rare disease and is easily misdiagnosed by esophagoscopic biopsy. The prognosis of EASC was similar to that of ESCC. Postoperative adjuvant chemotherapy may improve the survival of patients with EASC after esophagectomy.

Occurrence and Prognosis of Mixed Subtype Adenocarcinoma and Adeno-Squamous Carcinoma in Esophageal Cancer

“…When EASC was located in the upper 1/3 of the esophagus, there was no local lymph node positivity, while when located in the middle 1/3 of the esophagus, the local lymph node positivity rate reached as high as 27.70%, indicating that the middle 1/3 of the esophagus in EASC is more likely to have local lymph node metastasis, and prognosis is closely related to the local lymph node positivity rate. The main location of ASC is still controversial in the literature, with some suggesting a preference for squamous cell carcinoma characteristics in the middle part of the esophagus [31,32], while others suggest a preference for adenocarcinoma characteristics in the distal esophagus [13,25]. In our data, 60.3% of patients were located in the lower 1/3 of the esophagus, indicating a preference for adenocarcinoma characteristics.…”

“…The main location of ASC is still controversial in the literature, with some suggesting a preference for squamous cell carcinoma characteristics in the middle part of the esophagus 31 , 32 , while others suggest a preference for adenocarcinoma characteristics in the distal esophagus 13 , 25 . In our data, 60.3% of patients were located in the lower 1/3 of the esophagus, indicating a preference for adenocarcinoma characteristics.…”

Clinical-Pathological Characteristics of Adenosquamous Esophageal Carcinoma: A Propensity-Score-Matching Study

“…We hypothesized that although ADSC confuses two different tumor components, the prognosis is not a general combination of the two. Coincidentally, Yendamuri et al and Chen et al reported that the prognosis of ADSC is consistent with that of SCC [ 34 , 35 ]. In addition, Yachida et al found that ADSC had better prognosis than SCC in their series of 18 patients with this disease [ 36 ].…”

Experience with chemotherapy for postoperative metastases of adenosquamous carcinoma of the esophagogastric junction and pathological study of its development

“…Regarding chemotherapy for advanced ASC, Chen argued that the prognosis was similar to that of esophageal squamous cell carcinoma [ 7 ]. Evans et al .…”