Verrucous esophageal carcinoma is a unique indolent subtype of squamous cell carcinoma: a systematic review and individual patient regression analysis

Li, Darrick K.; Haffar, Samir; Horibe, Masayasu; Homsi, Haya A; Zukerberg, Lawrence; Murad, Mohammad Hassan; Visrodia, Kavel; Gala, Manish; Katzka, David A.; Bazerbachi, Fateh

doi:10.1007/s00535-020-01736-1

Cited by 12 publications

(10 citation statements)

References 31 publications

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“…Another strength of our study was in implelemting a novel methodology of combining a case study, systematic review, and case-control analysis approach. 16 , 32 A systematic review alone may be insufficient to provide guidance in informing decisions in care. 13 Combining health system data with a systematic review approach can further strengthen the evidence and enhance the applicability of systematic review findings.…”

Section: Discussionmentioning

confidence: 99%

Microangiopathic Hemolytic Anemia Is a Late and Fatal Complication of Gastric Signet Ring Cell Carcinoma: A Systematic Review and Case-Control Study

et al. 2022

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Background Microangiopathic hemolytic anemia (MAHA) is a rare paraneoplastic syndrome that has been reported in patients with gastric signet ring cell carcinoma (SRCC). Clinical and prognostic features of MAHA in this setting have been poorly described. Materials and Methods We conducted a systematic review in 8 databases of gastric SRCC complicated by MAHA and performed a case-control study assessing factors associated with survival in patients with gastric SRCC and MAHA in our pooled cohort compared with age-, sex-, and stage-matched cases of gastric SRCC from the Surveillance, Epidemiology, and End Results (SEER) database. Descriptive analyses were performed and multivariable Cox-proportional hazards regression modeling was used to determine factors associated with overall survival. Results All identified patients (n = 47) were symptomatic at index presentation, commonly with back/bone pain, and dyspnea. Microangiopathic hemolytic anemia was the first manifestation of gastric SRCC in 94% of patients. Laboratory studies were notable for anemia (median 7.7 g/dL), thrombocytopenia (median 45.5 × 103/μL), and hyperbilirubinemia (median 2.3 mg/dL). All patients with MAHA had metastatic disease at presentation, most often to the bone, bone marrow, and lymph nodes. Median survival in patients with gastric SRCC and MAHA was significantly shorter than a matched SEER-derived cohort with metastatic gastric SRCC (7 weeks vs 28 weeks, P < .01). In multivariate analysis, patients with MAHA were at significantly increased risk of mortality (HR 3.28, 95% CI 2.11-5.12). Conclusion Microangiopathic hemolytic anemia is a rare, late-stage complication of metastatic gastric SRCC and is associated with significantly decreased survival compared with metastatic gastric SRCC alone.

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Section: Discussionmentioning

confidence: 99%

Microangiopathic Hemolytic Anemia Is a Late and Fatal Complication of Gastric Signet Ring Cell Carcinoma: A Systematic Review and Case-Control Study

et al. 2022

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“…The same two reviewers assessed the methodological quality of included studies with a discussion between them in case of disagreement. This tool has been previously applied with consistent agreement among reviewers in several studies 19‐27 …”

Section: Methodsmentioning

confidence: 99%

Liver chemistries in glycogenic hepatopathy associated with type 1 diabetes mellitus: A systematic review and pooled analysis

Haffar¹,

Izzy

Habib

et al. 2021

Liver International

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Background & Aims Glycogenic hepatopathy (GH) in type 1 diabetes‐mellitus (T1DM) is characterized by hepatomegaly and perturbations of liver chemistries (LC) that have not been well studied. Furthermore, misdiagnosis with other hepatic complications of T1DM, such as nonalcoholic fatty liver disease, has been described. We perform a systematic review of biopsy‐proven GH reports in T1DM patients to identify LC patterns. Methods A systematic review identified reports of biopsy‐proven GH in patients with T1DM. We excluded GH with other liver diseases, Mauriac syndrome, or GH without T1DM. Two reviewers screened and extracted studies and assessed their methodological quality. LC elevation magnitude, AST‐to‐ALT ratio, R‐ratio to designate hepatocellular, cholestatic or mixed pattern of hepatic injury, and evolution of transaminases after glycemic control were analyzed. Results A total of 192 patients were included, with median age of 20 years, 73% adults, 66% females, median duration of T1DM before diagnosis 10 years, median adult body mass index 21 kg/m2, median HbA1c 12%, at least one episode of diabetic ketoacidosis 70%, and hepatomegaly 92%. ALT and AST showed moderate‐to‐severe elevation in 78% and 76%, respectively, AST/ALT >1 in 71% and hepatocellular to mixed pattern of hepatic injury in 81%. Transaminase improvement with glycemic control was the rule, regardless of other factors in multilinear regression analysis. Conclusion GH tends to have AST‐predominant elevation with a median of 13 times the upper normal limit and R‐ratio >2, which may distinguish it from other etiologies of AST‐predominant LC elevation, and in the appropriate clinical context, may obviate invasive tests.

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“…45 Until now, about 135 VC cases have been reported in 82 publications. 46 In a systemic review of the reported VC cases, the male to female ratio was about 2:1. The patients' ages ranged from 30 to 90 years old, with a median age of 65.…”

Section: Verrucous Squamous Cell Carcinomamentioning

confidence: 99%

“…Twenty-seven percent of the patients had a significant history of alcohol and tobacco use. 46 The medical history was often significant for gastroesophageal reflux disease, chronic esophageal irritation, achalasia, esophageal diverticulum, caustic injury, esophageal stricture, Candida esophagitis, and hiatal hernia. Most patients were symptomatic at the time of diagnosis, with dysphagia and weight loss being the most common symptoms, followed by odynophagia, hematemesis, cough, and anemia.…”

Section: Verrucous Squamous Cell Carcinomamentioning

confidence: 99%

Histomorphology and Molecular Profiling of Well-Differentiated Squamous Cell Carcinoma of the Esophagus Including its Unusual Variants

Yin¹,

Wang²,

Amofa-Ho³

et al. 2022

J Clin Transl Pathol

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Esophageal verrucous squamous cell carcinoma and esophageal carcinoma cuniculatum are rare variants of extremely well-differentiated squamous cell carcinoma. These rare tumors share similar risk factors and clinical presentations with conventional esophageal squamous cell carcinoma. However, these tumors have distinct morphological features, molecular mutation profiles, and clinical outcomes. Diagnosis of esophageal verrucous squamous cell carcinoma and esophageal carcinoma cuniculatum can be challenging, requires high clinical suspicion, and often can only be diagnosed on a deep mucosal biopsy or resection specimen. Surgical treatment or endoscopic resection can be curative in early disease. This review presents the histomorphology and molecular profiling of the conventional type and the rare variants of the esophageal well-differentiated squamous cell carcinoma.

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Verrucous esophageal carcinoma is a unique indolent subtype of squamous cell carcinoma: a systematic review and individual patient regression analysis

Cited by 12 publications

References 31 publications

Microangiopathic Hemolytic Anemia Is a Late and Fatal Complication of Gastric Signet Ring Cell Carcinoma: A Systematic Review and Case-Control Study

Microangiopathic Hemolytic Anemia Is a Late and Fatal Complication of Gastric Signet Ring Cell Carcinoma: A Systematic Review and Case-Control Study

Liver chemistries in glycogenic hepatopathy associated with type 1 diabetes mellitus: A systematic review and pooled analysis

Histomorphology and Molecular Profiling of Well-Differentiated Squamous Cell Carcinoma of the Esophagus Including its Unusual Variants

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