Abstract 144P
Background
The Keratinizing squamous cell carcinoma (SCC) is a malignant epithelial tumor with unclear incidence. It has cellular differentiation characterized by keratinization. Early lesions can be treated by endoscopic submucosal dissection or esophagectomy while the advanced stages benefit from neoadjuvant chemo(radio)therapy. Present day, due to its scarcity, there are no established data extracted about this subtype. So, we aimed to assess the impact of different treatment modalities on the survival outcome of oesophageal keratinizing SCC.
Methods
The Surveillance, Epidemiology, and End Results (SEER) database was used to extract the data of patients diagnosed with Oesophageal keratinizing SCC from 2000 to 2021. We used the ICD-O-3 histological code 8071/3. We had five treatment groups; adjuvant chemo(radio)therapy, surgery with no systemic therapy, primary combined chemoradiotherapy, primary chemotherapy and primary radiotherapy. SPSS version 29 was used for data analysis. Kaplan-Meier curve and Log-Rank test were used for survival analysis.
Results
Out of 82,128 oesophageal cancer cases, 1493 (2.45%) had keratinizing SCC. The majority were males with a 5-year relative survival of 13.0% compared to females (19.6%, P <0.001). Caucasians had an improved 5-year relative survival compared to African-Americans and other races (19.3%, 8.6% and 14.1%, P<0.001). Adjuvant chemo(radio)therapy had an improved 5-year relative survival compared to surgery with no systemic therapy, primary combined chemoradiotherapy, primary chemotherapy and primary radiotherapy (42.8%, 39.9%, 14.8%, 5.7% and 4.1%, respectively, P<0.001).
Conclusions
Oesophageal Keratinizing SCC had a poor survival outcome, was more common in males and Caucasians. Surgery with no systemic therapy had quite similar survival outcome to adjuvant chemo(radio)therapy. However, both modalities had significant survival benefit compared to the non-surgical management. These results highlight the surgical management with no systemic therapy as the modality of choice to avoid unnecessary serious side effects of the systemic therapies for improved quality of life after the treatment.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.