Abstract
Objective: Esophageal adenosquamous carcinoma (ASC) is a rare pathological type of cancer. Its clinical features and prognosis is poorly understood. The purpose of this study was to identify the characteristics of ASC patients and analyze the risk factors of esophageal carcinoma.Methods: Patients with esophageal cancer in the SEER database diagnosed from 1975–2016 were obtained. The epidemiology, clinical characteristics, and outcomes between these three groups were compared. The nomogram and online dynamic nomogram were constructed according to the Cox proportional hazard model.Results: The age-adjusted incidences of AC (1975–1999), AC (1999–2016), and ASC (1975–1989) increased over time (p < 0.05). Age-adjusted incidences of SqCC (1986–2012) and ASC (1989–2016) decreased (p < 0.05). Survival of patients with ASC was significantly worse when compared to AC and SqCC (ASC vs. AC, p < 0.001, ASC vs. SqCC, p = 0.01). ASC, older age, black race, male, overlapping site, higher tumor grade, lymph node metastasis, and a higher summary stage or AJCC stage were considered to be risk factors for a poor survival in the multivariate Cox analysis. The ROC curves and AUC indicated that the model has a good discrimination ability (AUC were 0.774 for a 3-year OS and 0.782 for a 5-year OS). An online dynamic nomogram was built based on the Cox proportional hazard model for convenient clinical use.Conclusions: ASC is somewhat closer to AC rather than SqCC in terms of the demographics and tumor site, but has a worse OS than both AC and SqCC.
Highlights
Esophageal cancer is the eighth most common cancer worldwide and the sixth leading cause of cancer-related mortality worldwide [1, 2]
Our study showed that the overall survival in patients with Adenosquamous carcinoma (ASC) is worse than that in patients with AC and Squamous Cell Carcinoma (SqCC)
We found that gender, race, and lymph node metastasis have no influence on the OS of ASC patients which is different from AC and SqCC
Summary
Esophageal cancer is the eighth most common cancer worldwide and the sixth leading cause of cancer-related mortality worldwide [1, 2]. Due to its rare incidence, ASC of the esophagus was rarely reported, most of which were single case reports or small case series [4,5,6,7,8,9,10,11,12]. These studies provided contradictory information regarding the clinical characteristics and prognosis of ASC. No consensus regarding these questions about ASC has been formed, so more studies are needed to explore the pathogenesis, biological behavior, treatment, clinical characteristics, and prognosis of ASC, and the differences among ASC, AC, and SqCC
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