Highlights
- •Colorectal adenosquamous carcinoma is very rare among colorectal cancers with paucity of data regarding its natural history and prognosis.
- •Patients with ASC are more likely to present with more advanced stages and distant metastases compared to patients with Adenocarcinoma and Squamous cell carcinoma.
- •In the colon, major surgery was the mainstay of treatment for ASC, while in the rectum surgery chemotherapy and/or radiation were utilized in different combinations.
- •On multivariable analysis, Adenosquamous cancer was associated with poor prognosis compared to Adenocarcinoma.
Abstract
Introduction
Colorectal adenosquamous carcinoma (ASC) represents <0.1% of colorectal cancers. Due
to its rarity, there is paucity of data regarding its prognosis and treatment compared
to other colorectal cancers. The aim of the study was to evaluate presentation, treatment
and prognosis of colorectal ASC in comparison to adenocarcinoma (AC) and squamous
cell carcinoma (SCC).
Methods
Adult patients diagnosed with colorectal AC, SCC, and ASC between 2000 and 2017 were
identified using Surveillance, Epidemiology, and End Results database.
Results
Among the 446,132 patients diagnosed with colorectal cancer, 0.06% had ASC and were
more likely to present with higher T stage and distant metastases compared to AC and
SCC (p < 0.001). Major surgery was the primary treatment for colonic ASC, while for
rectal ASC, chemotherapy and/or radiation were mainly utilized. Localized and distant
colonic ASC had an unadjusted 5-year cause-specific survival that was worse than AC,
while rectal ASC had the worst survival across all stages.
Conclusion
Colorectal ASC usually present with advanced stage and have overall worse prognosis.
Standardization of treatment strategies may improve survival in colorectal ASC.
Keywords
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Article info
Publication history
Published online: September 10, 2021
Accepted:
September 6,
2021
Received in revised form:
August 31,
2021
Received:
June 7,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
