Prognosis After Curative Resection of Esophageal Basaloid Squamous Cell Carcinoma: A Single-Institution Retrospective Study.

Abstract

BACKGROUND: Although several studies have described the clinicopathologic features of esophageal basaloid squamous cell carcinoma (EBSCC), its prognosis after curative esophagectomy remains unclear in the modern treatment era. METHODS: This study retrospectively reviewed 803 patients who underwent subtotal esophagectomy at Kumamoto University Hospital between April 2005 and December 2023. Clinicopathologic features of EBSCC, including response to neoadjuvant chemotherapy and survival outcomes, were compared with those of conventional esophageal squamous cell carcinoma (ESCC). RESULTS: Among the 803 patients, 33 (4.1 %) had a diagnosis of EBSCC. Of these, 10 EBSCC and 248 ESCC patients received neoadjuvant chemotherapy. None of the EBSCC patients achieved a pathologic response greater than grade 2, whereas 27.8 % of the ESCC patients did (p = 0.01). Recurrence was experienced by for 11 of the 33 EBSCC patients and 218 of the 770 ESCC patients. Hematogenous recurrence was significantly more frequent in EBSCC (82 % vs. 27 %), whereas lymph node recurrence was less common (18 % vs 53 %). Overall survival (OS) was comparable between the groups, with 5-year OS rates of 68.2 % for EBSCC and 70.2 % for ESCC (p = 0.61, log-rank). CONCLUSION: Despite its resistance to neoadjuvant chemotherapy and a higher tendency for hematogenous metastasis, EBSCC exhibits a prognosis comparable with that of ESCC after curative esophagectomy.