Adenosquamous Carcinoma of the Esophagus and Esophagogastric Junction: Clinical Manifestations and Treatment Outcomes

J Gastrointest Surg. 2015 Jul;19(7):1216-22. doi: 10.1007/s11605-015-2852-x. Epub 2015 May 13.


Background/aims: The aim of this study is to understand the clinicopathological manifestations, treatment, and prognostic factors of adenosquamous carcinoma (ASC) of the esophagus and esophagogastric junction, a rare malignancy.

Methods: From 1981 to 2011, 26 out of 4704 patients (23 males, 3 females; mean age: 65.8 years) with ASC of the esophagus and esophagogastric junction who received surgical resection were analyzed.

Results: Only one (4.2%) patient was diagnosed with ASC by preoperative endoscopic biopsy. Three patients received Ivor-Lewis operation with intrathoracic esophagogastrostomy, seven received gastrectomies, and the other 16 underwent transthoracic esophagectomies. Median follow-up time was 30.6 months (interquartile range, 17.9-95.1 months). At study end, there were 12 (46.2%) patients with tumor relapse, all within 3 years postoperatively. The 5-year disease-free survival (DFS) rate was 46.2%. Tumor length and no postoperative adjuvant treatment were the independent prognostic factors for DFS. The 5-year overall survival (OS) rate was 30.8%. On multivariate analysis, the resection type, tumor length, and perineural invasion were independent prognostic factors for OS.

Conclusion: ASC is a rare cell type of the esophagus and esophagogastric junction that is easily misdiagnosed at endoscopic biopsy. OS rate was no worse than that reported for squamous cell carcinoma (SCC). Tumor length was the independent prognostic factor for both DFS and OS.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Anastomosis, Surgical
  • Carcinoma, Adenosquamous / drug therapy
  • Carcinoma, Adenosquamous / pathology*
  • Carcinoma, Adenosquamous / surgery*
  • Chemotherapy, Adjuvant
  • Disease-Free Survival
  • Esophageal Neoplasms / drug therapy
  • Esophageal Neoplasms / pathology*
  • Esophageal Neoplasms / surgery*
  • Esophagectomy
  • Esophagogastric Junction / surgery*
  • Female
  • Follow-Up Studies
  • Gastrectomy
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness
  • Neoplasm Recurrence, Local* / surgery
  • Peripheral Nerves / pathology
  • Retrospective Studies
  • Survival Rate
  • Treatment Outcome
  • Tumor Burden