Adenosquamous carcinoma: An aggressive histologic sub-type of colon cancer with poor prognosis

Am J Surg. 2021 Mar;221(3):649-653. doi: 10.1016/j.amjsurg.2020.07.038. Epub 2020 Aug 22.

Abstract

Background: Studies have reported worse overall survival (OS) for adenosquamous carcinoma (ASC) compared to adenocarcinoma (AC) of the colon, but none have analyzed a national dataset for over 30 years.

Methods: The National Cancer Database was queried from 2004 to 2016 for patients with ASC and AC of the colon. Kaplan-Meier survival analysis was performed to assess OS. Descriptive variables were evaluated using independent T-test and Chi-square analyses.

Results: 332 ASC patients were compared to 496,950 AC patients. AC patients were older than ASC patients (68.6 vs. 64.4 years); p < 0.001. Most ASC cancers presented with stage IV (41.3%) and poorly-differentiated disease (57.5%) compared to AC (22.4% and 17.7%). OS of the ASC cohort was 13.9 months. Median OS for stage IV AC versus stage IV ASC was significantly better (14.1 vs. 8.0 months); p < 0.0001.

Conclusion: This is the largest national database study to compare ASC with AC. Our findings confirm that unlike AC, ASC most frequently presents late stage, as poorly-differentiated lesions, and have worse OS.

Keywords: Adenocarcinoma; Adenosquamous; Kaplan-meier survival; Poorly-differentiated; Stage IV.

MeSH terms

  • Adenocarcinoma / mortality*
  • Adenocarcinoma / pathology*
  • Adenocarcinoma / therapy
  • Aged
  • Carcinoma, Adenosquamous / mortality*
  • Carcinoma, Adenosquamous / pathology*
  • Carcinoma, Adenosquamous / therapy
  • Colonic Neoplasms / mortality*
  • Colonic Neoplasms / pathology*
  • Colonic Neoplasms / therapy
  • Female
  • Humans
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Neoplasm Staging
  • Prognosis
  • Retrospective Studies