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Clinical predictors of special type of esophageal cancer

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Abstract

Background

Esophageal cancers with a histological type other than the two major types, squamous cell carcinoma (SCC) and adenocarcinoma, are referred to as “special type of esophageal cancer” (STEC). STEC is rare and difficult to diagnose preoperatively. Therefore, we aimed to clarify the clinicopathological findings of STEC, including magnifying endoscopy with narrow band imaging (ME-NBI).

Methods

We reviewed 1133 lesions in 936 consecutive cases who underwent endoscopic resection or surgical resection for primary esophageal cancer. Patients were classified into the SCC group and the STEC group, respectively. Factors that predict STEC endoscopically, as well as clinicopathologic features of STEC compared to SCC, were examined.

Results

Twenty-eight STECs were diagnosed in 28 patients: 15 with basaloid squamous cell carcinoma, 6 with adenosquamous carcinoma, 4 with mucoepidermoid carcinoma, 1 with carcinosarcoma, 1 with salivary duct-type carcinoma, and 1 with neuroendocrine cell carcinoma. There was significantly more pT1b or deeper cancer (60.7% vs. 12.8%), lymphovascular invasion (50.0% vs. 11.1%) and elevated type (53.6% vs. 16.1%) in the STEC group. The proportion of lesions with type R vessels on ME-NBI was significantly higher in the STEC group (46.4% vs. 3.9%). The STEC group had significantly lower accuracy of ME-NBI for prediction of depth (64.3% vs. 83.5%) and a greater proportion of underestimated lesions (32.1% vs. 9.3%). In the multivariate analysis, the histopathology of STEC was associated with type R vessels on ME-NBI.

Conclusion

Type R vessels and submucosal tumor-like elevation might be the clinical predictors of STEC.

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Data availability

All data generated or analyzed during this study are included in this article. Further enquiries can be directed to the corresponding author.

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Funding

This study has not received any fundings.

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Authors and Affiliations

  1. Department of Gastroenterology, Toranomon Hospital, 2-2-2 Toranomon, Minato-ku, Tokyo, 105-8470, Japan

    Yugo Suzuki, Mako Koseki, Kosuke Nomura, Akira Matsui, Daisuke Kikuchi & Shu Hoteya

  2. Department of Gastroenterological Surgery, Toranomon Hospital, Tokyo, Japan

    Yu Ohkura & Masaki Ueno

  3. Department of Human Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan

    Kenichi Ohashi

Authors
  1. Yugo Suzuki
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  2. Yu Ohkura
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  3. Mako Koseki
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  4. Kosuke Nomura
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  5. Akira Matsui
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  6. Masaki Ueno
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  7. Daisuke Kikuchi
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  8. Kenichi Ohashi
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  9. Shu Hoteya
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Contributions

Conceptualization: YS. Methodology: YS. Investigation: all authors. Writing—original draft: YS. Writing—review and editing: YS. Approval of final manuscript: all authors.

Corresponding author

Correspondence to Yugo Suzuki.

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Ethical statement

The study was approved by the Institutional Review Board of Toranomon Hospital (approval number 2268) and was performed in accordance with the 1964 Declaration of Helsinki and its later revisions. All patients consented in writing to undergo the proposed procedure. Written informed consent for inclusion in the study was not mandatory in view of the retrospective observational nature of the research. However, patients were given the opportunity to opt out via the hospital’s website.

Conflict of interest

Yugo Suzuki, Yu Ohkura, Mako Koseki, Kosuke Nomura, Akira Matsui, Masaki Ueno, Daisuke Kikuchi, Kenichi Ohashi and Shu Hoteya declare that they have no conflicts of interest.

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Suzuki, Y., Ohkura, Y., Koseki, M. et al. Clinical predictors of special type of esophageal cancer. Esophagus 20, 484–491 (2023). https://doi.org/10.1007/s10388-023-01003-1

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  • DOI: https://doi.org/10.1007/s10388-023-01003-1

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