The clinicopathological features and prognostic factors of gastric squamous cell carcinoma

Abstract

Primary gastric squamous cell carcinoma (SCC) is an exceedingly rare disease. We increased the understanding of gastric SCC and evaluated prognostic factors of gastric SCC.In this large-population cohort study, we retrospectively collected 163 primary gastric SCC and 66,209 primary gastric adenocarcinoma cases from the surveillance, epidemiology, and end results program (SEER) database from 1988 to 2012. The Chi-squared test demonstrated the distributed differences. Cox proportional hazards regression model was used to evaluate the prognostic factors.Gastric SCC accounted for 0.2% of all the primary gastric cancer cases. The mean age of patients with gastric SCC was 69.6 years old, and the man-to-woman ratio was 2.3:1. The proportion of black was higher in gastric SCC than gastric adenocarcinoma (P < 0.001). Almost half of the gastric SCCs were diagnosed in stage IV and more than half were poorly differentiated. In gastric SCC, the median survival was 8.0 months and the 5-year overall survival (OS) was 32.7%; in gastric adenocarcinoma the median survival rate was 19.0 months and the 5-year OS was 35.4%. The multivariate analysis showed that number of primary lesions, tumor location, grade, and stage were independent prognostic factors in gastric SCC. The tumor stage was the most important prognostic factor.Primary gastric SCC is exceedingly rare. Compared with gastric adenocarcinoma, gastric SCC was more frequent in black patients and was usually diagnosed when it was poorly differentiated and at a later stage. On the whole, gastric SCC has a poorer outcome. Disease stage is likely a key determinant in survival.

Gastric squamous cell carcinoma and gastric adenosquamous carcinoma, clinical features and outcomes of rare clinical entities: a National Cancer Database (NCDB) analysis

“…GSCC tends to originate in the proximal stomach and present at advanced stage. These findings parallel prior reports (1,3,16). Recent results from a SEER database study, identified 163 cases of GSCC (1).…”

“…The clinical outcomes of GSCC and GASC individually and compared to GAC varies significantly in institutional case series and literature reviews. For example, 5-year OS of GSCC ranges between 13% and 32% in the literature and is 17.4% in this study (1,15). Median OS survival ranges between 7 and 8 months and is 8.9 months in this study (1,19).…”

“…Surgical resection for GSCC was reported to be utilized between 32% and 95% of cases in the literature, in comparison to 26% in the current study (1,16). Radiation therapy was used in approximately a third of the patients in the SEER database study and 48.1% in the current study, whereas no radiation was used in the study by Wakabayashi et al (1,16). Use of adjuvant and neoadjuvant therapy ranges between 2% and 34% in the published literature.…”

“…For example, 5-year OS of GSCC ranges between 13% and 32% in the literature and is 17.4% in this study (1,15). Median OS survival ranges between 7 and 8 months and is 8.9 months in this study (1,19). The 5-year OS of GASC ranges between 15.4% and 26.4% in the literature and is 14.7% in this study (18,20).…”

“…Gastric adenocarcinoma (GAC) is the most common primary gastric cancer. Gastric squamous cell carcinoma (GSCC) accounts for 0.2% of primary gastric cancers (1,2). Published literature on GASC and GSCC is limited to case reports and institutional case series.…”