Shen Jiangfeng, Lu Kaijin, Liu Fuxing, Chen Xia, Chen Quan, Wu Bingbing, Wang Hailan, Ge Pengfei, Han Guang, Wang Fei, Zhang Peng, Yin Pei, Jia Weiguang, Zheng Yiming, Wang Pengcheng, Sun Fei
Department of Thoracic Surgery, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, China.
Department of Pathology, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, China.
Front Oncol. 2024 Aug 21;14:1387611. doi: 10.3389/fonc.2024.1387611. eCollection 2024.
Carcinosarcoma is a rare esophageal tumor, accounting for approximately 0.27-2.8% of malignant esophageal tumors. This study aims to investigate the clinical pathological characteristics, surgical treatment outcomes, and analysis of prognostic factors in esophageal carcinosarcoma (ECS).
Clinical data from sixteen patients diagnosed with esophageal sarcomatoid carcinoma who underwent surgical interventions were retrospectively analyzed. Clinical and pathological features, treatment modalities, and postoperative outcomes were systematically examined.
Out of the 1261 patients who underwent surgical treatment for esophageal cancer, 16 cases were pathologically confirmed as carcinosarcoma. Among them, two underwent neoadjuvant chemotherapy, six received postoperative chemotherapy. Carcinosarcomas predominantly occurred in the middle (43.75%) and lower (50%) segments of the esophagus. Among the 16 cases, 10 presented as polypoid, 4 as ulcerative, and 2 as medullary types. Microscopic examination revealed coexistence and transitional transitions between sarcomatous and carcinoma components. Pathological staging showed 5 cases in stage T1, 2 in stage T2, and 9 in stage T3, with lymph node metastasis observed in 8 cases (50%). TNM staging revealed 2 cases in stage I, 9 in stage II, and 5 in stage III. The overall 1, 3, and 5-year survival rates were 86.67%, 62.5%, and 57.14%, respectively. Univariate analysis indicated that pathological N staging influenced survival rates, while multivariate analysis demonstrated that pathological N staging was an independent prognostic factor.
Carcinosarcoma is a rare esophageal tumor, accounting for approximately 0.27-2.8% of malignant esophageal tumors. Histologically, the biphasic pattern is a crucial diagnostic feature, although the carcinomatous component may not always be evident, especially in limited biopsies, leading to potential misclassification as pure sarcoma or squamous cell carcinoma. Despite its large volume and cellular atypia, carcinosarcoma carries a favorable prognosis. Complete surgical resection of the tumor and regional lymph node dissection is the preferred treatment approach for esophageal carcinosarcoma.
癌肉瘤是一种罕见的食管肿瘤，约占恶性食管肿瘤的0.27 - 2.8%。本研究旨在探讨食管癌肉瘤（ECS）的临床病理特征、手术治疗效果及预后因素分析。
回顾性分析16例诊断为食管肉瘤样癌并接受手术干预患者的临床资料。系统检查临床和病理特征、治疗方式及术后结果。
在1261例行食管癌手术治疗的患者中，16例经病理确诊为癌肉瘤。其中，2例接受新辅助化疗，6例接受术后化疗。癌肉瘤主要发生于食管中段（43.75%）和下段（50%）。16例中，10例为息肉样，4例为溃疡型，2例为髓样型。显微镜检查显示肉瘤成分和癌成分共存及移行过渡。病理分期显示T1期5例，T2期2例，T3期9例，8例（50%）有淋巴结转移。TNM分期显示I期2例，II期9例，III期5例。总体1年、3年和5年生存率分别为86.67%、62.5%和57.14%。单因素分析表明病理N分期影响生存率，多因素分析显示病理N分期是独立的预后因素。
癌肉瘤是一种罕见的食管肿瘤，约占恶性食管肿瘤的0.27 - 2.8%。组织学上，双相模式是关键的诊断特征，尽管癌成分可能并不总是明显，尤其是在有限活检中，可能导致误分类为纯肉瘤或鳞状细胞癌。尽管癌肉瘤体积大且细胞异型性明显，但预后良好。肿瘤的完整手术切除及区域淋巴结清扫是食管癌肉瘤的首选治疗方法。
