- Volume 14 Issue 3
DOI QR Code
Clinical Outcomes of Basaloid Squamous Cell Carcinoma of the Esophagus: A Retrospective Analysis of 142 Cases
- Zhang, Bai-Hua (Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College) ;
- Cheng, Gui-Yu (Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College) ;
- Xue, Qi (Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College) ;
- Gao, Shu-Geng (Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College) ;
- Sun, Ke-Lin (Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College) ;
- Wang, Yong-Gang (Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College) ;
- Mu, Ju-Wei (Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College) ;
- He, Jie (Department of Thoracic Surgery, Cancer Hospital and Institute, Chinese Academy of Medical Sciences and Peking Union Medical College)
- 발행 : 2013.03.30
Background: Basaloid squamous cell carcinoma of the esophagus (BSCCE) is a rare and distinctive tumor with no standard treatment. This study aimed to explore treatment in relation to prognosis of the disease. Methods: A total of 142 patients with BSCCE that underwent treatment in our hospital from March 1999 to July 2010 were retrospectively analyzed. All patients received surgery, 42 postoperative radiotherapy and 28 patients chemotherapy. Results: There were 26 patients included in stage I, 60 in stage II, 53 in stage III and 3 in stage IV. The clinical symptoms and macroscopic performances of BSCCE did not differ from those of typical esophageal squamous cell carcinoma. Among 118 patients receiving endoscopic biopsy, only 12 were diagnosed with BSCCE. The median survival time (MST) of the entire group was 32 months, with 1-, 3- and 5-year overall survival (OS) of 81.4%, 46.8% and 31.0%, respectively. The 5-year OS of stage I and II patients was significantly longer than that of stages III/IV, at 60.3%, 36.1% and 10.9%, respectively (p<0.001, p=0.001). The MST and 5-year OS were 59.0 months and 47.4% in patients with tumors located in the lower thoracic esophagus, and 27.0 months and 18.1% in those with lesions in the upper/middle esophagus (p=0.002). However, the survival was not significantly improved in patients undegoing adjunctive therapy. Multivariate analysis showed TNM stage and tumor location to be independent prognostic factors. Furthermore, distant metastasis was the most frequent failure pattern, with a median recurrence time of 10 months. Conclusion: BSCCE is an aggressive disease with rapid progression and a propensity for distant metastasis. It is difficult to make a definitive diagnosis via preoperative biopsy. Multidisciplinary therapy including radical esophagectomy with extended lymphadenectomy should be recommended, while the effectiveness of radiochemotherapy requires further validation for BSCCE.
- Abe K, Sasano H, Itakura Y, et al (1996). Basaloid-squamous carcinoma of the esophagus. A clinicopathologic, DNA ploidy, and immunohistochemical study of seven cases. Am J Surg Pathol, 20, 453-61. https://doi.org/10.1097/00000478-199604000-00008
- Altorki NK, Skinner DB (1997). Occult cervical nodal metastasis in esophageal cancer: preliminary results of three-field lymphadenectomy. J Thorac Cardiovasc Surg, 113, 540-4. https://doi.org/10.1016/S0022-5223(97)70368-4
- Berger B, Stahlberg K, Lemminger A, et al (2011). Impact of radiotherapy, chemotherapy and surgery in multimodal treatment of locally advanced esophageal cancer. Oncology, 81, 387-94. https://doi.org/10.1159/000335263
- Chen SB, Weng HR, Wang G, et al (2012). Basaloid squamous cell carcinoma of the esophagus. J Cancer Res Clin Oncol, 138, 1165-71. https://doi.org/10.1007/s00432-012-1180-8
- Cho KJ, Jang JJ, Lee SS, Zo JI (2000). Basaloid squamous carcinoma of the oesophagus: a distinct neoplasm with multipotential differentiation. Histopathology, 36, 331-40. https://doi.org/10.1046/j.1365-2559.2000.00851.x
- Fok M, Sham JS, Choy D, Cheng SW, Wong J (1993). Postoperative radiotherapy for carcinoma of the esophagus: a prospective, randomized controlled study. Surgery, 113, 138-47.
- Gabbert HE, Nakamura Y, Shimoda T, et al (2000). Squamous cell carcinoma of the esophagus. In: Hamilton SR, Aaltonen LA (ed.) World Health Organization Classification of Tumours. Pathology and Genetics of Tumours of the Digestive System. Lyon: IARC Press, 11-9.
- Huang Z, Liang Y, Wu X (1995). Basaloid squamous carcinoma of the oesophagus: a distinctive clinico-pathological entity. Zhonghua Bing Li Xue Za Zhi, 24, 90-2.
- Imamhasan A, Mitomi H, Saito T, et al (2012). Immunohistochemical and oncogenetic analyses of the esophageal basaloid squamous cell carcinoma in comparison with conventional squamous cell carcinomas. Hum Pathol, 43, 2012-23. https://doi.org/10.1016/j.humpath.2012.02.010
- Kobayashi Y, Nakanishi Y, Taniguchi H, et al (2009). Histological diversity in basaloid squamous cell carcinoma of the esophagus. Dis Esophagus, 22, 231-8. https://doi.org/10.1111/j.1442-2050.2008.00864.x
- Lam KY, Law S, Luk JM, Wong J (2001). Oesophageal basaloid squamous cell carcinoma: a unique clinicopathological entity with telomerase activity as a prognostic indicator. J Pathol, 195, 435-42. https://doi.org/10.1002/path.984
- Lerut T, Nafteux P, Moons J, et al (2004). Three-field lymphadenectomy for carcinoma of the esophagus and gastroesophageal junction in 174 R0 resections: impact on staging, disease-free survival, and outcome: a plea for adaptation of TNM classification in upper-half esophageal carcinoma. Ann Surg, 240, 962-72; https://doi.org/10.1097/01.sla.0000145925.70409.d7
- Li TJ, Zhang YX, Wen J, et al (2004). Basaloid squamous cell carcinoma of the esophagus with or without adenoid cystic features. Arch Pathol Lab Med, 128, 1124-30.
- Mariette C, Piessen G, Briez N, Triboulet JP (2008). The number of metastatic lymph nodes and the ratio between metastatic and examined lymph nodes are independent prognostic factors in esophageal cancer regardless of neoadjuvant chemoradiation or lymphadenectomy extent. Ann Surg, 247, 365-71. https://doi.org/10.1097/SLA.0b013e31815aaadf
- Matsubara T, Ueda M, Nagao N, et al (1998). Cervicothoracic approach for total mesesophageal dissection in cancer of the thoracic esophagus. J Am Coll Surg, 187, 238-45. https://doi.org/10.1016/S1072-7515(98)00159-8
- Morice WG, Ferreiro JA (1998). Distinction of basaloid squamous cell carcinoma from adenoid cystic and small cell undifferentiated carcinoma by immunohistochemistry. Hum Pathol, 29, 609-12. https://doi.org/10.1016/S0046-8177(98)80011-7
- Owonikoko T, Loberg C, Gabbert HE, Sarbia M (2001). Comparative analysis of basaloid and typical squamous cell carcinoma of the oesophagus: a molecular biological and immunohistochemical study. J Pathol, 193, 155-61. https://doi.org/10.1002/1096-9896(2000)9999:9999<::AID-PATH758>3.0.CO;2-D
- Rizk NP, Ishwaran H, Rice TW, et al (2010). Optimum lymphadenectomy for esophageal cancer. Ann Surg, 251, 46-50. https://doi.org/10.1097/SLA.0b013e3181b2f6ee
- Sarbia M, Verreet P, Bittinger F, et al (1997). Basaloid squamous cell carcinoma of the esophagus: diagnosis and prognosis. Cancer, 79, 1871-8. https://doi.org/10.1002/(SICI)1097-0142(19970515)79:10<1871::AID-CNCR5>3.0.CO;2-J
- Schreiber D, Rineer J, Vongtama D, et al (2010). Impact of postoperative radiation after esophagectomy for esophageal cancer. J Thorac Oncol, 5, 244-50. https://doi.org/10.1097/JTO.0b013e3181c5e34f
- Soriano E, Faure C, Lantuejoul S, et al (2008). Course and prognosis of basaloid squamous cell carcinoma of the head and neck: A case-control study of 62 patients. Eur J Cancer, 44, 244-50. https://doi.org/10.1016/j.ejca.2007.11.008
- Stilidi I, Davydov M, Bokhyan V, Suleymanov E (2003). Subtotal esophagectomy with extended 2-field lymph node dissection for thoracic esophageal cancer. Eur J Cardiothorac Surg, 23, 415-20. https://doi.org/10.1016/s1010-7940(02)00801-1
- Takemura M, Yoshida K, Fujiwara Y, Sakurai K, Takii M (2012). A case of long-term survival after pulmonary resection for metachronous pulmonary metastasis of basaloid squamous cell carcinoma of the esophagus. Int J Surg Case Rep, 3, 451-4. https://doi.org/10.1016/j.ijscr.2012.05.013
- Yang HX, Hou X, Liu QW, et al (2012). Tumor location does not impact long-term survival in patients with operable thoracic esophageal squamous cell carcinoma in China. Ann Thorac Surg, 93, 1861-6. https://doi.org/10.1016/j.athoracsur.2012.03.002
- Yoshino A, Shibasaki H,Okada N, et al (2012). Lung metastasis of basaloid-squamous cell carcinoma of the esophagus; report of a case. Kyobu Geka, 65, 335-7.
- Zhang XH, Sun GQ, Zhou XJ, Guo HF, Zhang TH (1998). Basaloid squamous carcinoma of esophagus:a clinicopathological, immunohistochemical and electron microscopic study of sixteen cases. World J Gastroenterol, 4, 397-403.
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- The Preoperative Neutrophil-To-Lymphocyte Ratio Is a Novel Immune Parameter for the Prognosis of Esophageal Basaloid Squamous Cell Carcinoma vol.11, pp.12, 2016, https://doi.org/10.1371/journal.pone.0168299
- Characteristics and diagnosis of esophageal basaloid squamous cell carcinoma vol.13, pp.1, 2016, https://doi.org/10.1007/s10388-015-0490-8
- Rare tumors of esophageal squamous mucosa vol.1381, pp.1, 2016, https://doi.org/10.1111/nyas.13108
- Comparative analysis of basaloid and conventional squamous cell carcinomas of the esophagus: prognostic relevance of clinicopathological features and protein expression vol.37, pp.5, 2016, https://doi.org/10.1007/s13277-015-4551-3
- Subcutaneous metastasis from recurrent basaloid squamous cell carcinoma of the esophagus pp.1477-092X, 2017, https://doi.org/10.1177/1078155217736920
- A novel gene expression scoring system for accurate diagnosis of basaloid squamous cell carcinoma of the esophagus vol.51, pp.3, 2017, https://doi.org/10.3892/ijo.2017.4075
- Esophageal Basaloid Squamous Carcinoma Treated by Endoscopic Resection and Radiation vol.72, pp.5, 2018, https://doi.org/10.4166/kjg.2018.72.5.258