Work

Computed tomography features and clinicopathological characteristics of resectable esophageal sarcomatoid carcinoma: a retrospective study

Year: 2025

Type: article

Abstract: Objectives: Esophageal sarcomatoid carcinoma (ESC) is a rare malignant tumor. This study aims to analyze the computed tomography (CT) features and clinicopathological characteristics of resectable ESC. Methods: l), the tumor-to-normal esophagus attenuation ratio (TNR), enhancement pattern, tumor margin, and tumor morphology, which was classified into two types: mass-forming type and wall-thickening type. Additionally, CT-measured tumor thickness (cTT), CT-measured tumor length (cTL), and CT-measured tumor volume (cTV) were measured and recorded. The analysis of clinicopathological characteristics encompassed variables such as age, gender, clinical symptoms, pathological tumor thickness (pTT), pathological tumor length (pTL), T stage, N stage, lymphovascular invasion status, and neural invasion status. To assess the agreement and correlation between CT features and pathological results, Bland-Altman plots and Pearson correlation coefficient analyses were performed for pTT versus cTT and pTL versus cTL, respectively. Results: Among the 25 patients with ESC, 19 were male and 6 were female. The patients' ages ranged from 47 to 73 years, with a mean age of 65.48 ± 6.85 years and a median age of 68 years. The pathological staging results showed that 14 cases were at stage T1, 5 cases at stage T2, 5 cases at stage T3, and 1 case at stage T4. Lymph node metastasis was identified in 12 cases, including 5 classified as N1, 4 as N2, and 3 as N3. The pTT ranged from 0.50 to 4.00 cm, with a mean of 1.92 ± 1.02 cm and a median of 1.50 cm; the cTT ranged from 0.60 to 4.10 cm, with a mean of 2.02 ± 0.90 cm and a median of 1.66 cm. Bland-Altman analysis demonstrated a mean difference of 0.10 cm between cTT and pTT, with 92.0% (23/25) of cases lying within the 95% limits of agreement (Mean ± 1.96 SD). The Pearson correlation coefficient between the two measurements was 0.980, indicating a strong positive correlation. The pTL ranged from 2.00 to 7.00 cm, with a mean of 4.24 ± 1.50 cm and a median of 4.00 cm; the cTL ranged from 2.57 to 7.50 cm, with a mean of 4.41 ± 1.48 cm and a median of 4.16 cm. Bland-Altman analysis demonstrated a mean difference of 0.18 cm between cTL and pTL, with 92.0% (23/25) of cases lying within the 95% limits of agreement. The Pearson correlation coefficient was 0.884. The cTV ranged from 1.56 cm³ to 41.49 cm³, with a median of 8.25 cm³. Regarding tumor morphology, 20 cases presented as mass-forming type, while 5 were classified as wall-thickening type. Significant differences in both pTT and cTT were observed between the two morphological types; however, no statistically significant differences were found in other CT features. Conclusion: ESC is a rare malignant tumor characterized by distinctive CT features. The majority of cases manifest as the mass-forming type, while a smaller proportion present as the wall-thickening type. The definitive diagnosis of ESC depends on pathological examination.

Source: Frontiers in Oncology

DOI: 10.3389/fonc.2025.1655957