Journal of the American College of Surgeons
Journal of the American College of Surgeons
5 years ago

Comparative Analysis of Clinical, Treatment, and Survival Characteristics of Basaloid and Squamous Cell Carcinoma of the Esophagus

Basaloid squamous cell carcinoma (BSC) is a rare variant of squamous cell carcinoma (SqCC) of the esophagus. Even though pathologically thought to be more aggressive than SqCC, there is discrepancy in the literature regarding the outcomes of BSC compared to SqCC. Study Design A retrospective cohort study conducted using the SEER database. All patients with a histologic diagnosis of BSC and SqCC between 2004 and 2013 were included. We compared treatment and survival characteristics of patients with BSC and SqCC. Results 16,158 patients were included in this study, [173 patients (1.1%) had BSC]. There were no significant differences between the 2 groups based on age, gender, marital status, insurance, or geographic region of diagnosis, but patients with BSC were more likely to be Caucasian (73.4% vs. 64.7%; p=0.017). Among staged patients, baseline tumor stage was similar between both groups. However, BSC tumors were more likely to be of high pathological grade (56.8% vs. 38.2%; p<0.001). Patients with SqCC were more likely to receive radiation therapy (36.9% vs. 53.9%; p<0.001), while patients with BSC were more likely to undergo resection (32.4% vs. 17.0%; p<0.001). Median overall survival was similar between both groups (14 vs. 9 months; Log Rank=0.144), and this relationship persisted following stratification by treatment. Conclusions Even though more likely to be poorly differentiated at presentation, BSC of the esophagus seems to have similar clinical features and survival outcomes when compared to SqCC. Patients with BSC and SqCC should undergo stage-specific treatment to achieve optimal outcomes.

Teaser

Esophageal basaloid squamous cell cancer (BSC), a rare variant of typical squamous cell cancer (SqCC) has more aggressive histologic characteristics compared to SqCC. However, survival outcomes are similar between BSC and SqCC, stratified for stage and treatment. Patients with BSC and SqCC should undergo stage-specific treatment to achieve optimal outcomes.

Publisher URL: www.sciencedirect.com/science

DOI: S1072751517320641

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