Primary adenosquamous carcinoma of the esophagus

Table 1 Clinopathologic features of the 37 patients with esophageal adenosquamous carcinoma

Gender	Age (yr)	Location	Length (cm)	Macroscopic tumor type	pT	pN	Operation	Treatment	Result	Last follow up (mo)
M	40	Lt	7	Medullary	4a	1	Radical	S + R	D	4
M	51	Mt	7	Medullary	3	2	Radical	S	D	19
F	74	Mt	8	Polypoid	4a	1	Radical	S	A	158
M	47	Mt	5	Medullary	3	1	Radical	S + R	A	114
M	64	Mt	7	Medullary	4a	0	Radical	S	D	2
F	51	Mt	3	Medullary	3	0	Radical	S	D	74
M	61	Ut	4	Medullary	1b	0	Radical	S	D	45
M	42	Ut	4	Sclerotic	4b	0	Palliative	S	D	20
M	50	Mt	3	Medullary	3	0	Radical	S	D	42
M	56	Mt	6	Ulcerative	3	0	Radical	S	D	21
M	60	Mt	3	Sclerotic	3	0	Radical	S + R	D1	140
M	63	Lt	4	Medullary	3	1	Radical	S	D	14
M	65	Mt	4	Sclerotic	3	0	Radical	S	D	26
M	67	Mt	10	Intraluminal	2	0	Radical	S	D	1
M	72	Mt	4	Medullary	3	1	Radical	S	D	11
M	56	Mt	4	Medullary	3	1	Radical	S	D	15
M	78	Mt	4	Medullary	2	1	Radical	S	D	12
F	66	Lt	2	Ulcerative	2	1	Radical	S + R	D	28
M	50	Mt	7	Medullary	4a	2	Radical	S + R	D	11
M	40	Mt	5	Medullary	1b	0	Radical	S	D	30
M	53	Mt	6	Medullary	3	1	Radical	S	D	25
F	54	Mt	4	Medullary	3	0	Radical	S	D	5
M	62	Mt	4	Medullary	3	3	Palliative	S + C	D	5
M	63	Mt	4	Medullary	3	0	Radical	S	A	85
M	63	Ut	6	Medullary	3	0	Radical	S	D	19
M	41	Mt	6	Medullary	3	1	Radical	S + R	A	80
M	47	Mt	6	Medullary	3	0	Radical	S	D	9
M	57	Mt	3	Polypoid	2	0	Radical	S	A	60
M	53	Mt	6	Medullary	3	3	Radical	S	D	10
M	65	Mt	3	Medullary	1b	0	Radical	S	D	33
M	56	Mt	3	Medullary	3	1	Radical	S + R	D	32
F	45	Mt	3	Medullary	3	0	Radical	S + R	L	16
M	63	Mt	7	Medullary	3	1	Radical	S + R	A	34
M	63	Lt	2	Medullary	1b	3	Radical	S	D	6
M	65	Mt	5	Medullary	3	1	Radical	S + R	D	20
F	73	Mt	5	Medullary	3	1	Radical	S	A	11
M	73	Lt	10	Medullary	4a	2	Palliative	S	D	2

F: Female; M: Male; Ut: Upper third of thoracic esophagus; Mt: Middle third of thoracic esophagus; Lt: Lower third of thoracic esophagus; S: Surgery; R: Radiotherapy; C: Chemotherapy; A: Alive; D: Die of tumor recurrence; D1: Die of myocardial infarction.

Table 2 Univariate analysis of the prognosis of the 37 patients with esophageal adenosquamous carcinoma

	Number of patients	Survival rate			MST (mo, 95%CI)	P value
		1-yr	3-yr	5-yr
Gender						0.302
Male	31	64.5%	25.8%	18.4%	20.0 (13.5-26.5)
Female	6	83.3%	55.6%	55.6%	74.0 (0.0-149.4)
Age (yr)						0.448
≤ 60	19	73.7%	34.2%	28.5%	25.0 (11.6-38.4)
> 60	18	60.6%	24.2%	16.2%	19.0 (8.6-29.4)
Location						0.031
Ut	3	100.0%	33.3%	0.0%	20.0 (18.4-21.6)
Mt	29	68.8%	34.5%	30.2%	25.0 (12.8-37.2)
Lt	5	40.0%	0.0%	0.0%	6.0 (1.7-10.3)
Length						0.630
≤ 4 cm	19	73.7%	34.4%	23.0%	28.0 (12.0-44.0)
> 4 cm	18	61.1%	24.4%	24.4%	19.0 (7.4-30.6)
Macroscopic tumor type						< 0.001
Medullary	29	61.9%	27.3%	18.2%	19.0 (11.7-26.3)
Intraluminal	1	0.0%	0.0%	0.0%	1.0
Polyploid	2	100.0%	100.0%	100.0%	-
Ulcerative	2	100.0%	0.0%	0.0%	21.0
Sclerotic	3	100.0%	33.3%	33.3%	26.0 (16.4-35.6)
pT category						0.573
pT1	4	75.0%	25.0%	0.0%	30.0 (3.5-56.5)
pT2	4	50.0%	25.0%	25.0%	12.0 (0.0-38.5)
pT3	23	78.3%	34.5%	28.8%	21.0 (12.4-29.6)
pT4	6	33.3%	16.7%	16.7%	4.0 (0.0-14.8)
pN category						0.002
pN0	17	76.5%	38.2%	25.5%	30.0 (12.8-47.2)
pN1	14	77.9%	31.2%	31.2%	25.0 (9.9-40.1)
pN2	3	33.3%	0.0%	0.0%	11.0 (0.0-25.4)
pN3	3	0.0%	0.0%	0.0%	6.0 (4.4-7.6)
Adjuvant radiotherapy						0.066
No	27	62.7%	23.5%	15.7%	19.0 (11.7-26.3)
Yes	10	80.0%	45.7%	45.7%	32.0
Operation						0.025
Radical	34	70.5%	32.2%	25.0%	25.0 (15.4-34.6)
Palliative	3	33.3%	0.0%	0.0%	5.0 (0.2-9.8)

Ut: Upper third of thoracic esophagus; Mt: Middle third of thoracic esophagus; Lt: Lower third of thoracic esophagus; MST: Median survival time.

Table 3 Multivariate Cox regression analysis for the prognosis of the 37 patients with esophageal adenosquamous carcinoma

Prognostic factor	Hazard ratio	95%CI	P value
Location	2.177	0.797-5.951	0.129
Macroscopic tumor type	1.002	0.633-1.585	0.995
pN category	1.656	0.956-2.871	0.072
Adjuvant radiotherapy	0.317	0.114-0.885	0.028
Operation	3.718	0.782-17.679	0.099

Table 4 Comparison of clinicopathological variables between patients with esophageal adenosquamous carcinoma and those with squamous cell carcinoma

Variable	ASC	SCC				P value
		Well differentiated (n = 1011)	Moderately differentiated (n = 2007)	Poorly differentiated (n = 421)	Total (n = 3439)
Gender						0.191
Male	31	748	1473	313	2534
Female	6	263	534	108	905
Age (yr)						0.056
≤ 60	19	672	1347	270	2289
> 60	18	339	660	151	1150
Location						0.647
Ut	3	124	284	54	462
Mt	29	746	1426	303	2475
Lt	5	141	297	64	502
Tumor length						0.182
≤ 4 cm	19	397	799	191	1387
> 4 cm	18	614	1208	230	2052
pT category						0.409
pTis	0	10	17	5	32
pT1a	0	18	35	10	63
pT1b	4	39	88	22	149
pT2	4	202	350	80	632
pT3	23	562	1135	232	1929
pT4a	5	139	278	68	485
pT4b	1	41	84	24	149
pN category						0.187
pN0	17	587	1049	212	1848
pN1	14	235	530	110	875
pN2	3	151	328	69	548
pN3	3	38	100	30	168
Adjuvant radiotherapy						1.000
No	27	729	1465	292	2486
Yes	10	282	542	129	953
Operation						0.755
Radical	34	945	1851	385	3181
Palliative	3	66	156	36	258

ASC: Adenosquamous carcinoma; SCC: Squamous cell carcinoma; Ut: Upper third of thoracic esophagus; Mt: Middle third of thoracic esophagus; Lt: Lower third of thoracic esophagus.

Table 5 Comparison of prognosis between patients with adenosquamous carcinoma and those with squamous cell carcinoma

	Cases	1-yr OS	3-yr OS	5-yr OS	MST (mo, 95%CI)
Well differentiated SCC	1011	87.5%	67.1%	58.9%	148.0
Moderately differentiated SCC	2007	81.0%	51.5%	42.5%	39.0 (34.7-43.3)
Poorly differentiated SCC	421	72.6%	37.3%	27.4%	22.0 (18.3-25.7)
Total SCC	3439	81.8%	54.3%	45.6%	46.0 (40.8-51.2)
ASC	37	67.5%	29.4%	22.9%	21.0 (12.6-29.4)

ASC: Adenosquamous carcinoma; SCC: Squamous cell carcinoma; OS: Overall survival rates; MST: Median survival time.