title: Clinicopathological characteristics, diagnosis, treatment, and outcomes of primary gastric adenosquamous carcinoma.
abstract: BACKGROUND
  Primary gastric adenosquamous carcinoma (ASC) is a rare subset of ASC. This study aims to investigate the clinicopathological features, diagnosis, treatment, and outcomes of primary gastric ASC.
  
  
  METHODS
  The medical records of 13 consecutive patients with primary gastric ASC between January 2010 and July 2014 from a single institutional database were reviewed.
  
  
  RESULTS
  Male predominance was observed (M/F = 10/3) among the patients, and their median age was 62 years (range: 43 to 79 years). The primary lesions were most often found in the upper third of the stomach, with a median tumor size of 5 cm (range: 2.25 cm to 10.5 cm). Ten patients underwent radical resections (R0 resection, 76.9%), while three patients had palliative resections (R1/R2 resection, 23.1%). Twelve patients had lymph node metastasis at the time of surgery. Adenocarcinoma and squamous cell carcinoma components in lymph node were found in eight and two cases, respectively, while two patients had both squamous cell carcinoma and adenocarcinoma components. In terms of the TNM staging system, stages IIB, IIIA, IIIB, IIIC, and IV were detected in 2 (15.4%), 2 (15.4%), 1 (7.7%), 5 (38.5%), and 3 (23.1%) patients, respectively. The median follow-up period was 22 months (range: 5 to 52 months); during which, four patients were still alive and eight patients died because of tumor progression. The 1-, 2-, and 3-year survival rates were 76.9%, 46.2%, and 15.4%, respectively.
  
  
  CONCLUSIONS
  Primary gastric ASC has a very poor prognosis, and both squamous cell carcinoma and adenocarcinoma components have distant metastasis potential.
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. hnchen7@gmail.com.
authors.forename: Haining
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. scyshenchaoyong@163.com.
authors.forename: Chaoyong
authors.initials: C
authors.lastname: Shen
authors.affiliation: Department of Pathology, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. 32284560@qq.com.
authors.forename: Rui
authors.initials: R
authors.lastname: Yin
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. Yinyuan10@gmail.com.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Yin
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. chenjiaju@whu.edu.cn.
authors.forename: Jiaju
authors.initials: J
authors.lastname: Chen
authors.affiliation: Intensive Care Unit, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, China. 641933094@qq.com.
authors.forename: Luyin
authors.initials: L
authors.lastname: Han
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. hxwcwk@126.com.
authors.forename: Bo
authors.initials: B
authors.lastname: Zhang
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. chenzhixin@medmail.com.cn.
authors.forename: Zhixin
authors.initials: Z
authors.lastname: Chen
authors.affiliation: Department of Gastrointestinal Surgery, West China Hospital, Sichuan University, 37 Guoxue Alley, Chengdu, 610041, Sichuan, China. 670176711@qq.com.
authors.forename: Jiaping
authors.initials: J
authors.lastname: Chen
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D018196:Carcinoma, Adenosquamous / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D002294:Carcinoma, Squamous Cell / Q000401:mortality / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000401:mortality*; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate