ABSTRACT
<p><b>OBJECTIVE</b>To analyze the clinicopathological characteristics and prognosis of a rare histological type of esophageal cancer-sarcomatoid carcinoma.</p><p><b>METHODS</b>Clinicopathological data of 31 patients with esophageal sarcomatoid carcinoma who underwent surgery in the Department of Thoracic Surgery of Zhejiang Cancer Hospital from Jan 2000 to Dec 2009 were collected and analyzed. The survival analysis was performed using Kaplan-Meier method.</p><p><b>RESULTS</b>All the patients underwent surgery. Of the 31 patients, one received preoperative chemoradiotherapy and postoperative chemotherapy, and 8 received postoperative chemotherapy. All the tumors were located in the middle or lower esophagus. Microscopically, the tumors were composed of both carcinomatous and sarcomatous components, and there was a transition between the two components, but no obvious heterogenous elements such as osteosarcoma, chondrosarcoma or rhabdomyosarcoma were found. In the carcinomatous components, positive expression of CK and EMA was found in all the 31 cases, and positive expression of vimentin in 5 of the 31 cases. In the sarcomatous components, positive expression of CK, EMA and vimentin was found in 29, 28 and 23 cases, respectively. The 1-, 3-, and 5-year survival rates were 80.6%, 55.9% and 33.4%, respectively, and the median survival time was 40 months.</p><p><b>CONCLUSIONS</b>Esophageal sarcomatoid carcinoma is a particular type of esophageal malignancy with unique clinicopathological features. The diversity and complexity of the carcinomatous and sarcomatous components and their potential of transformation and differentiation lead to different prognosis from each other.</p>
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Antineoplastic Combined Chemotherapy Protocols , Therapeutic Uses , Carcinosarcoma , Metabolism , Pathology , General Surgery , Therapeutics , Chemoradiotherapy, Adjuvant , Chemotherapy, Adjuvant , Esophageal Neoplasms , Metabolism , Pathology , General Surgery , Therapeutics , Esophagectomy , Methods , Follow-Up Studies , Keratins , Metabolism , Mucin-1 , Metabolism , Prognosis , Survival Rate , Vimentin , MetabolismABSTRACT
<p><b>OBJECTIVE</b>To study the related factors of right recurrent nerve nodal involvement in esophageal cancer.</p><p><b>METHODS</b>280 patients with thoracic esophageal cancer received esophagectomy and right recurrent nerve node dissection. The clinicopathological data were analyzed retrospectively. Univariate data were analyzed by chi-square test, and multivariate data were analyzed by logistic regression.</p><p><b>RESULTS</b>The right recurrent nerve nodal metastasis was found in 76 cases (27.1%, 76/280). In the 979 excised right recurrent nerve nodes, metastases were found in 118 nodes (12.1%). The tumor staging, the total number of involved lymph nodes, vascular invasion, the number of lymph node metastases in the thorax, the number of lymph node metastasis in the abdomen, subcarinal node metastasis, and peri-esophageal lymph node metastasis were independent risk factors of right recurrent nerve node metastasis in esophageal carcinoma.</p><p><b>CONCLUSION</b>Right recurrent nerve lymph nodes should be dissected in those patients with high risk factors of lymph node metastasis in thoracic esophageal carcinoma.</p>
Subject(s)
Adult , Aged , Female , Humans , Male , Middle Aged , Esophageal Neoplasms , Pathology , General Surgery , Esophagectomy , Logistic Models , Lymph Node Excision , Lymph Nodes , Pathology , General Surgery , Lymphatic Metastasis , Recurrent Laryngeal Nerve , Pathology , Retrospective Studies , Risk FactorsABSTRACT
Objective To study the clinicopathologic characteristics of sarcomatoid carcinoma of the lung.Methods Clinicopathologic characteristics and immunohistochemical results of 42 cases with sarcoma- toid carcinoma of the lung were analyzed.Results Forty-two cases were pathologically proved to be spindle cell carcinoma,1 cases;giant cell carcinoma,1 case;carcinosarcoma,4 cases;pleomorphic carcinoma,36 cases.The tumors were composed of both carcinomatous and sarcomatous elements.Immunohistochemistry showed that CK was positive in 24 of 24 cases,EMA was positive in 18 of 20 cases,Vim was positive in 25 of 25 cases.Eighteen cases were survival One-year survival rate was 61.2 %,with mean survival 13.3 months. Conclusion Diagnosis of sarcomatoid carcinoma of the lung depends on pathologic and immunohistochemical results.
ABSTRACT
<p><b>OBJECTIVE</b>To analyze the complications and treatment results of intraoperative radiotherapy (IORT) for esophageal carcinoma.</p><p><b>METHODS</b>Sixty patients with thoracic esophageal carcinoma underwent esophagectomy through right thoractomy, 30 patients of whom received IORT of 15 - 25 Gy.</p><p><b>RESULTS</b>In patients who underwent IORT, 2 cases of pneumonitis, 1 case of anastomotic leak and 1 case of incisional wound infection were found. In patients underwent surgery only, 1 case of thoracic empyema and 1 case of anastomotic leak were found. All the complications ultimately healed. There was no operative mortality. During the follow-up of 3 years, in patients who underwent IORT, 2 of 3 died of radiation pneumonitis 24 and 26 months after IORT with one complicated with bronchoesophageal fistula. One of 3 died of multiple lung metastases. The 3-year survival rate was 88.0% (22/25) in IORT group and 76.0% (19/25) in surgery only group.</p><p><b>CONCLUSION</b>Intraoperative radiotherapy can reduce locoregional recurrence if performed to thoracic esophageal carcinoma patients without surgical contraindication or distant metastasis. Radiation pneumonitis, a common complication difficult to manage, implies a poor prognosis and, consequently, the lung and bronchus should be protected from the radiation.</p>