Adenosquamous carcinoma of the esophagus. Clinicopathologic study of 18 cases.
OBJECTIVE
Adenosquamous carcinoma (ASC) of the esophagus is an uncommon form of esophageal cancer. Despite isolated case reports on this tumor type, no large clinicopathologic series appears to have been studied at a single institution.


METHODS
At our institution, 20 cases of ASC were diagnosed pathologically between 1970 and 2001 (20/2,056 total esophageal cancers; 1.0%). Excluding 2 patients who received preoperative radiation therapy, 18 were selected for review of their clinicopathologic features, including survival time, in comparison with those of patients with conventional squamous cell carcinomas (SCCs; n = 850) and adenocarcinomas (ACs; n = 40) of the esophagus.


RESULTS
The location and macroscopic type of the ASCs were similar to those of the SCCs. ASC tumors were significantly smaller than SCC (p = 0.004) and AC (p = 0.012) tumors, and the depth of invasion of ASCs was significantly less than that of SCCs (p = 0.028). Lymphatic permeation and blood vessel invasion were seen in 14 (77.8%) and 7 (38.9%) of the 18 patients with ASCs, respectively, and intraepithelial carcinoma contiguous to the main lesion was evident in 10 cases (56.6%). The cumulative postoperative survival rates of patients with ASC at 3, 5 and 10 years were 71.5, 63.6 and 47.7%, respectively, the outcome being significantly better than for patients with either SCC (p = 0.027) or AC (p = 0.013).


CONCLUSIONS
In the esophagus, ASCs have better prognosis than conventional SCCs or ACs, probably due to their smaller size and lower stage.
Yachida
Shinichi
S
Clinical Laboratory Division, National Cancer Center Hospital, Tokyo, Japan.
Nakanishi
Yukihiro
Y
Shimoda
Tadakazu
T
Nimura
Satoshi
S
Igaki
Hiroyasu
H
Tachimori
Yuji
Y
Kato
Hoichi
H
D000368:Aged; D000369:Aged, 80 and over; D018196:Carcinoma, Adenosquamous / Q000473:pathology* / Q000556:secondary; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary / Q000473:pathology; D012189:Retrospective Studies; D016019:Survival Analysis