A Rare Subtype of Non-small Cell Lung Cancer: Report of 159 Resected Pathological Stage I–IIIA Pulmonary Lymphoepithelioma-Like Carcinoma Cases

Abstract

Background: The current study analyzed resected stage I–IIIA pulmonary lymphoepithelioma-like carcinoma (LELC) cases to define the clinical characteristics, prognosis and long-term outcomes of resected LELC, with the purpose of guiding clinical management for this rare tumor.Methods: Resected stage I–IIIA LELC, adenocarcinoma (ADC) and squamous cell carcinoma (SCC) cases from our center were enrolled. Propensity score matching (PSM) was applied to minimize the selection bias. Overall survival (OS) and disease-free survival (DFS) were compared between groups. Multivariate analyses were performed to identify the prognostic factors, and a nomogram was developed.Results: A total of 159 LELCs, 2,757 ADCs, and 1,331 SCCs were included. LELC, dominated among younger patients and non-smokers. LELC was a poorly differentiated disease that lacked driver gene mutations and was positive for immunohistochemistry indicators of squamous cell lineage. Survival analyses revealed that OS was significantly better for LELC than for other common non-small cell lung cancers (NSCLCs) both before PSM (all P < 0.001) and after PSM (all P < 0.05). Further analyses revealed that early pathological node stage and preoperative albumin level ≥35 were identified as independent prognostic factors favoring OS and DFS.Conclusions: LELC, dominated among younger and non-smoking populations, lacked driver gene mutations and was positive for immunohistochemistry indicators of squamous cell lineage. The survival outcome of LELC was better than other common NSCLCs.

Clinicopathological features and survival of rare primary pulmonary lymphoepithelial carcinoma: A cohort from a single center

“…The cohort comprised slightly more female patients than male patients. The female: male ratio was 1.07:1; the difference was not significant, which was consistent with most research reports 10,11 . However, a few studies reported the opposite ratio 12–14 .…”

“…The female: male ratio was 1.07:1; the difference was not significant, which was consistent with most research reports. 10,11 However, a few studies reported the opposite ratio. [12][13][14] We supposed that it was because of the small number of patients enrolled in the studies.…”

“…These findings were consistent with previous reports. [10][11][12][13][14][15][16] However, most patients with SCC had a history of smoking.…”

“…The censored data are defined as patients do not experience the terminal event before the study end or lost to follow‐up during the study period. In general, the postoperative follow‐up was performed every 3 months for the first 2 years, every 6 months for the next 3–5 years, and annually thereafter 10 . At each follow‐up visit, chest CT scans with and without contrast were used to monitor for recurrence.…”

“…In general, the postoperative follow-up was performed every 3 months for the first 2 years, every 6 months for the next 3-5 years, and annually thereafter. 10 At each follow-up visit, chest CT scans with and without contrast were used to monitor for recurrence. If the patient had specific symptoms, further investigation with a PET-CT or brain magnetic resonance imaging scan was required.…”