Abstract
e15705
Background: Adenocarcinoma with cartilaginous and osseous metaplasia is a rare and aggressive cancer. This variant is characterized by the presence of both glandular epithelial components and heterologous mesenchymal elements, such as cartilage and bone, contributing to its unique histopathology and clinical behavior. Treatment typically involves a multimodal approach including surgery, chemotherapy, and radiation with resistance to chemotherapy being common. Due to its rarity, the demographic and clinical characteristics remain poorly understood, this study leverages the National Cancer Database (NCDB) to explore demographic, clinical, and socioeconomic factors associated with adenocarcinoma with cartilaginous and osseous metaplasia, addressing a critical gap in the literature. Methods: A retrospective cohort analysis utilizing the 2004-2020 National Cancer Database (NCDB) included patients with histologically confirmed diagnosis of Adenocarcinoma with cartilaginous and osseous metaplasia (N = 212). Demographic variables, including age, sex, race, and socioeconomic status, were analyzed. Clinical characteristics, such as tumor stage, treatment modalities (surgery, chemotherapy, radiation therapy), and survival outcomes, were evaluated. Results: The cohort was predominantly female (98.1%), mostly White (74.5%) and non-Hispanic (87.7%) with a median age of 62 years. The majority of cases were diagnosis at early stages (Stage I: 32.1%; Stage II; 39.2%). Treatment included primary chemotherapy (75.5%) and radiation (51.9%). Surgical resection with negative margins was achieved in 91.5% of cases. Kaplan-Meier survival analysis revealed a mean survival time of 140.29 months (95% CL: 125.05-155.53). A subset of cases with cartilaginous and osseous metaplasia demonstrated distinct clinical features, including larger tumor size and higher rates of hematogenous metastasis. Conclusions: This study highlights a predominantly female cohort with adenocarcinoma, where early-stage diagnosis and surgical resection with negative margins are central to disease management. Treatment often included primary chemotherapy and radiation. These findings emphasize the importance of surgical resection and the need for further research into this rare and aggressive variant to optimize treatment strategies and improve outcomes.