Epidemiology and survival outcomes in adenosquamous carcinoma: a population-based study

Cheng, Chien‐Hong; Luo, Zan; Xiong, Wei; Shi, Zhongquan; Tan, Hui

doi:10.1007/s00384-022-04198-4

Cited by 5 publications

(8 citation statements)

References 31 publications

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“…Because these cancers comprise less than 0.3% of all malignancies, the literature on this histology is extremely spare. There is a pressing need to better understand the underlying tumor biology, as several reports have suggested that the incidence of these malignancies is rising [ 18 , 19 ]. Gathered primarily from limited series, the prevailing understanding of ASC clinical behavior is that patients with these malignancies have more aggressive disease progression compared to site-matched ACs or SCCs [ 20 , 21 ].…”

Section: Discussionmentioning

confidence: 99%

Epidemiology of Adenosquamous Carcinomas

Benesch,

Ramos-Santillan,

Rog

et al. 2024

World J Oncol

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Background Adenosquamous carcinomas (ASCs) are a very rare histology containing cancer cells with both glandular-like (adeno) and squamous cell histologies, comprising typically a fraction of a percent of all solid tumors. The bulk of the literature on ASCs is comprised of case reports and small series, with the general finding that ASCs tend to have worse outcomes than either of their parent histologies. However, there is a lack of pan site-comparative studies in the literature that compare ASC clinicodemographic and survival outcomes with those of conventional adenocarcinomas (ACs) and squamous cell carcinomas (SCCs). Methods In this study, we summarize these outcomes in eight primary sites, comprising 92.7% of all ASC cases diagnosed from 1975 to 2020 in the Surveillance, Epidemiology, and End Results (SEER) database. Results Lung ASCs comprise 51.5% of all ASC cases, accounting for 1.1% of all lung cancer cases, followed by uterine/cervical cancers at 29.7% of all ASC cases, translating into 1.8% of all cancers in this site. In descending order, the remaining 20% of ASCs arise in pancreatic, oral cavity, biliary, esophageal, colorectal, and gastric sites, comprising between 0.1% and 0.7% of all cancers in these sites. Apart from pancreatic and oral cavity cancers, ASC tumors tended to favor higher rates of regional or distant disease at presentation with poor tumor differentiation compared to either AC or SCC histologies. After multivariable analysis, adjusting for age, sex, detection stage, grade differentiation, surgery, chemotherapy, and radiotherapy, except for oral cavity cancers, ASCs tended to have worse overall survivals compared to ACs (hazard ratios: 1.1 - 1.6) and SCC (1.0 - 1.3), with colorectal ASCs having the worse overall survival compared to colorectal ACs, with a hazard ratio of 1.4 (95% confidence interval: 1.3 - 1.6). Conclusions Overall, these results suggest that ASC outcomes are site specific, and in general, tend to have worse outcomes than nonvariant ACs and SCCs even after correction for common clinical and epidemiological factors. These cancers have a poorly understood but unique tumor biology that warrants further characterization.

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Section: Discussionmentioning

confidence: 99%

Epidemiology of Adenosquamous Carcinomas

Benesch,

Ramos-Santillan,

Rog

et al. 2024

World J Oncol

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“…The CSS of ASC patients depends on the primary tumor location. Additionally, tumor location is an important factor in guiding the use of chemotherapy and radiation therapy 15 , and EASC patients had the highest survival rates with preoperative radiation therapy and adjuvant chemotherapy. Preoperative radiation therapy patients had OS rates of 73.8%, 37.0%, and 30.0% at 1, 3, and 5 years, while adjuvant chemotherapy patients had OS rates of 83.3%, 66.7%, and 33.3%.…”

Section: Discussionmentioning

confidence: 99%

“…Hence, the World Health Organization's classification of digestive system tumors defines the pathological characteristics of esophageal adeno-squamous carcinoma as lesions in the esophagus containing significant SCC elements mixed with tubular AC elements 9 , 14 . Esophageal adeno-squamous carcinoma accounts for approximately 3.1% of all adeno-squamous carcinomas in the body 15 and 1% of all esophageal cancers 16 . Adenocarcinoma exhibits a tendency for local infiltration.…”

Section: Introductionmentioning

confidence: 99%

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

Zhang,

Lu,

Guo

et al. 2024

J. Cancer

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Purpose: To gain a deeper understanding of the incidence and survival rates of rare esophageal mixed adenoacanthoma (EAM) and esophageal mixed adeno-squamous carcinoma (EASC) to promote a more comprehensive understanding of these two subtypes. Background: EAM and EASC are rare subtypes of esophageal cancer with limited literature available. Extensive research has been conducted on the clinical and pathological characteristics of gastric and colorectal mixed adenoacanthomas, but there is relatively little literature on esophageal mixed adenoacanthomas. Therefore, this study aims to investigate the incidence and survival rates of these two subtypes in depth. Methods: Patients diagnosed with EAM and EASC between 2000 and 2019 were selected from the SEER database for the study. Joinpoint software was used to calculate the incidence rates of esophageal AM and ASC patients, and differences in cancer overall survival (OS) and cancer-specific survival (CSS) based on Kaplan-Meier curves were compared. Multivariate Cox regression analysis was employed to identify independent prognostic factors for OS and CSS, and a prognostic model was established and validated for accuracy. Results: The study found that the incidence of EAM increased until 2014, followed by a decline, while the incidence of EASC decreased until 2017, followed by an increase. Both of these subtypes were more common in male patients and those over the age of 65. For EAM patients, preoperative chemoradiotherapy was associated with better survival rates, while for EASC patients, preoperative radiotherapy combined with adjuvant chemotherapy improved survival. Finally, we constructed nomograms for predicting the overall survival of EAM and EASC patients by incorporating identified risk factors, which demonstrated good sensitivity and specificity. Conclusion: EAM and EASC are rare subtypes of esophageal cancer, and an in-depth exploration of their incidence and survival rates provides valuable data and insights for understanding these rare esophageal cancer subtypes. This information can assist clinical decision-making for healthcare professionals.

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“…There are five developmental hypotheses for ASC of the stomach [ 3 , 4 ]. [ 1 ] squamous transformation of adenocarcinoma, [ 2 ] carcinogenesis of ectopic squamous epithelium, [ 3 ] carcinogenesis of the metaplastic non-neoplastic squamous cells, [ 4 ] differentiation of multipotent undifferentiated cancer cells into both glandular and squamous cells, and [ 5 ] collision of adenocarcinoma and squamous cell carcinoma at the same time.…”

Section: Discussionmentioning

confidence: 99%

“…On the other hand, there are several hypotheses for the development of ASC of the esophagus [ 1 ] originating from the esophageal intrinsic gland or conduit epithelium, [ 2 ] ASC originating from the mucosa and first developing into SCC, followed by differentiation of the adenocellular cells into adenosquamous cells, [ 3 ] simultaneous collision of AC and SCC [ 1 , 5 , 6 ].…”

Section: Discussionmentioning

confidence: 99%

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

Mita,

Oda,

Shimaguchi

et al. 2024

Journal of Surgical Case Reports

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We report here a case of postoperative recurrent adenosquamous carcinoma (ASC) of the esophagogastric junction (EGJ) treated with S-1 therapy. A 79-year-old woman was diagnosed with carcinoma of the EGJ. Thoracoscopic subtotal esophagectomy was performed, and pathological examination revealed advanced ASC with lymph node metastasis. Five months after surgery, multiple lung metastases and multiple lymph node metastases were observed, and the patient was treated with S-1 monotherapy, which showed partial response and may be effective for advanced ASC of the EGJ. On the other hand, immunohistological analysis of the tumors showed a relatively wide range of areas that could differentiate into both adenocarcinoma and squamous cell carcinoma, suggesting that tumor cells with multidifferentiation potential, or at least the ability to differentiate into both adeno-epithelial and squamous epithelial cells, were the likely source of the tumors.

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Epidemiology and survival outcomes in adenosquamous carcinoma: a population-based study

Cited by 5 publications

References 31 publications

Epidemiology of Adenosquamous Carcinomas

Epidemiology of Adenosquamous Carcinomas

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

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

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