title: Esophageal carcinosarcoma: a unique entity with better prognosis.
abstract: BACKGROUND
  Esophageal carcinosarcoma is a rare kind of malignancy, and how to identify the patients with poor prognosis is critical for improving treatment efficacy and survival outcome.
  
  
  METHODS
  The clinical characteristics, pathologic features, treatments, and outcomes of esophageal carcinosarcoma were analyzed in 33 patients. Meanwhile, we hypothesized that elevated neutrophil to lymphocyte ratio (NLR) correlates with poor prognosis.
  
  
  RESULTS
  Most patients had polypoid tumors, and the carcinomatous elements were squamous in all patients except one with adenosquamous carcinoma. Eight patients had elevated NLR (≥5). The median follow-up time was 39.1 (range, 0.5-178.2) months. The median overall survival time (OS) was 43.5 months, and the 1-, 3-, and 5-year OS rates were 74, 57, and 48%, respectively. Tumor recurrence occurred in 15 patients, and the median relapse-free survival time (RFS) was 23.9 months, and the 2-year RFS rate was 50%. For patients who received curative resection, OS and RFS were significantly associated with preoperative NLR. In the multivariate Cox regression model, higher NLR was an independent prognostic factor (P value was 0.001 for both OS and RFS).
  
  
  CONCLUSIONS
  Our study identified the baseline NLR to be an independently prognostic factor for curatively resected esophageal carcinosarcoma.
authors.affiliation: Department of Hematologic Oncology, Cancer Center, Sun Yat-sen University, Guangzhou, Guangdong, People's Republic of China.
authors.forename: Liang
authors.initials: L
authors.lastname: Wang
authors.forename: Yongbin
authors.initials: Y
authors.lastname: Lin
authors.forename: Hao
authors.initials: H
authors.lastname: Long
authors.forename: Hui
authors.initials: H
authors.lastname: Liu
authors.forename: Huilan
authors.initials: H
authors.lastname: Rao
authors.forename: Youjian
authors.initials: Y
authors.lastname: He
authors.forename: Tiehua
authors.initials: T
authors.lastname: Rong
authors.forename: Ying
authors.initials: Y
authors.lastname: Liang
mesh_terms: D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D002296:Carcinosarcoma / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D004938:Esophageal Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007124:Immunoenzyme Techniques; D008214:Lymphocytes / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D011379:Prognosis; D015996:Survival Rate