Prognosis and prognostic factors of esophageal spindle cell carcinoma treated by esophagectomy: a retrospective single-institution analysis

Hashimoto, Masashi; Kitagami, Hidehiko; Niwa, Hiroki; Kikkawa, Tomohiro; Ohuchi, Tomoyuki; Takenouchi, Toshinao; Hosokawa, Masao

doi:10.1007/s10388-019-00667-y

Cited by 18 publications

(27 citation statements)

References 11 publications

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“…Typical esophageal carcinosarcoma demonstrates a polypoid growth pattern and the neoplasm usually does not infiltrate deeply into the esophageal wall. Patients therefore have a symptom of dysphagia at the earlier stage and the survival outcome of patients with esophageal carcinosarcoma is generally better than that of patients with typical squamous cell carcinoma of the same size (Wang et al 2013;Yoshimoto et al 2018;Hashimoto et al 2019). Although the etiology of sarcomatous spindle cells remains unclear, a concept of monoclonal origin from a single ancestor cell was proposed, in which sarcomatous components could be derived from carcinomatous components via EMT or sarcomatous metaplasia (Sung et al.…”

Section: Discussionmentioning

confidence: 99%

“…Thus, DCF that could be effective for both carcinomatous and sarcomatous components may be a rational option of preoperative chemotherapy for patients with esophageal carcinosarcoma. 21%-42% of patients with esophageal carcinosarcoma underwent adjuvant therapy after surgery (Zhang et al 2016;Schizas et al 2018;Hashimoto et al 2019). However, no survival improve-ments have been reported so far because patients in more advanced stage received postoperative therapy.…”

Section: Discussionmentioning

confidence: 99%

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Esophageal Carcinosarcoma with Basaloid Squamous Cell Carcinoma: A Case Report and Review of the Literature

Ishida

Fujishima

Onodera

et al. 2019

Tohoku J. Exp. Med.

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Esophageal carcinosarcoma is a rare tumor composed of neoplastic squamous epithelium and sarcomatous spindle cells. The origin of spindle cells remains unknown; however, the majority of sarcomatous components are currently considered to be derived from existing carcinomatous cells via epithelial-mesenchymal transition (EMT). We report a case of esophageal carcinosarcoma harboring basaloid squamous cell carcinoma successfully treated with preoperative chemotherapy. A 78-year-old man complaining dysphagia was diagnosed as esophageal carcinosarcoma. After two courses of preoperative chemotherapy with cisplatin and 5-fluorouracil, curative esophagectomy with lymph node dissection was performed thoracoscopically. Histopathological findings of the resected specimen revealed the mixture of basaloid squamous cell carcinoma and sarcomatous spindle cells. A transitional zone between both components was also detected. As fibrosis was identified around both two components, the findings indicated that both carcinomatous and sarcomatous neoplasms disappeared by preoperative chemotherapy. Final pathological diagnosis was esophageal carcinosarcoma with basaloid squamous cell carcinoma. No recurrent lesions have been detected for 25 months after the surgery. Sarcomatous spindle cells could be derived from the components of basaloid squamous cell carcinoma in our present case due to the presence of histological transition between two components. In addition, the marked immunoreactivity of vimentin (an EMT marker) detected in the tumor cells of basaloid squamous cell carcinoma could be consistent with the concept of monoclonal origin via EMT. The regimen targeting squamous cell carcinoma could also be effective in the treatment of sarcomatous components. Preoperative therapy might achieve the improvement of clinical outcome of patients with esophageal carcinosarcoma.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Esophageal Carcinosarcoma with Basaloid Squamous Cell Carcinoma: A Case Report and Review of the Literature

Ishida

Fujishima

Onodera

et al. 2019

Tohoku J. Exp. Med.

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“…Therefore, histological confirmation is vital for the final diagnosis. However, preoperative biopsies usually produce negative results, and consequently a more effective method is needed to accomplish diagnosis[ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Endoscopic palliative resection of a giant 26-cm esophageal tumor: A case report

Li¹,

Guo²,

Ma³

et al. 2020

WJCC

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BACKGROUND Esophageal carcinosarcoma, usually presenting as a pedunculated polypoid mass, is a rare malignancy with coexisting sarcomatoid and carcinomatous components. Its imaging and endoscopic characteristics are similar to those of leiomyosarcoma, liposarcoma and so forth. The diagnosis needs histological confirmation. Surgical resection is the traditional therapy. Endoscopic resection is minimally invasive but still controversial. This paper reports the case of a patient with a giant esophageal carsinosarcoma who underwent a palliative endoscopic resection. CASE SUMMARY A 55-year-old male patient presented with dysphagia and weight loss for 1 mo. Imaging and endoscopy showed a gray-white, polypoid, stalk-like mass, with a bulky pedicle located in the middle and lower esophagus. The mass almost filled the whole esophageal lumen, but the endoscope could still pass through. Despite the suspicion of a malignancy, repeated biopsies indicated necrosis and inflammation. After multidisciplinary team consultation, an endoscopic resection to diagnose and relieve the obstruction was recommended. The pedicle of the mass was cut off, the bleeding was stopped, and the mass was cut into pieces and pulled out. The mass was 26 cm × 5 cm × 4 cm in size. The final diagnosis was esophageal carcinosarcoma. No postoperative complications occurred. After 1 mo, the patient gained 6 kg and endoscopic reexamination revealed no obstruction. Radical surgery with lymph node dissection was carried out successfully. This lesion was the largest endoscopically resected esophageal carcinosarcoma reported to date. CONCLUSION Endoscopic palliative resection can help obtain adequate tissue for diagnosis and relieve obstructions in patients with giant esophageal carcinosarcoma.

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“…In addition, the depth of tumor invasion in ECS is often limited to the superficial tumor layer [ 4 ]. On the contrary, ulcerative-type ECSs are often associated with a poor prognosis due to deeper tumor invasion compared with polypoid-type tumors [ 4 , 5 ]. Therefore, tumor type may be an important factor that can predict prognosis and guide the treatment plan.…”

Section: Introductionmentioning

confidence: 99%

“…However, several reports suggested that the frequency of lymph node metastasis in ECS is equivalent to that of squamous cell carcinoma [ [6] , [7] , [8] ]. Although the prognosis of ECS patients was considered equivalent to or slightly better than that of patients with squamous cell carcinoma, this concept is still controversial [ 5 , 6 , 9 , 10 ]. The possibility exists that the stratification of patients with ECS according to tumor type may provide clearer evaluation of treatment outcomes in these patients.…”

Section: Introductionmentioning

confidence: 99%

Esophageal carcinosarcoma in which the sarcomatous element has sloughed off: A case report

Sasaki

Iwaya

Akiyama

et al. 2020

International Journal of Surgery Case Reports

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Prognosis and prognostic factors of esophageal spindle cell carcinoma treated by esophagectomy: a retrospective single-institution analysis

Cited by 18 publications

References 11 publications

Esophageal Carcinosarcoma with Basaloid Squamous Cell Carcinoma: A Case Report and Review of the Literature

Esophageal Carcinosarcoma with Basaloid Squamous Cell Carcinoma: A Case Report and Review of the Literature

Endoscopic palliative resection of a giant 26-cm esophageal tumor: A case report

Esophageal carcinosarcoma in which the sarcomatous element has sloughed off: A case report

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