Adenosquamous carcinoma of the lung: surgical results as compared with squamous cell and adenocarcinoma cases

Maeda, Hitoshi; Matsumura, Akira; Kawabata, Tsutomu; Suito, Tetsushi; Kawashima, Osamu; Watanabe, Takeshi; Okabayashi, Kan; Kubota, Ichiro

doi:10.1016/j.ejcts.2011.05.050

Cited by 75 publications

(75 citation statements)

References 13 publications

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“…1 Within NSCLC, adenocarcinoma (ADC) and squamous cell carcinoma (SCC) are the two major subtypes, with distinct prognoses and therapeutic remedies. 2,3 …”

Section: Introductionmentioning

confidence: 99%

Comprehensive Computational Pathological Image Analysis Predicts Lung Cancer Prognosis

Luo

Zang

Yang

et al. 2017

Journal of Thoracic Oncology

166

136

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Introduction Pathological examination of histopathological slides is a routine clinical procedure for lung cancer diagnosis and prognosis. Although the classification of lung cancer has been updated to become more specific, only a small subset of the total morphological features are taken into consideration. The vast majority of the detailed morphological features of tumor tissues, particularly tumor cells’ surrounding microenvironment, are not fully analyzed. The heterogeneity of tumor cells and close interactions between tumor cells and their microenvironments are closely related to tumor development and progression. The goal of this study is to develop morphological feature–based prediction models for the prognosis of patients with lung cancer. Method We developed objective and quantitative computational approaches to analyze the morphological features of pathological images for patients with NSCLC. Tissue pathological images were analyzed for 523 patients with adenocarcinoma (ADC) and 511 patients with squamous cell carcinoma (SCC) from The Cancer Genome Atlas lung cancer cohorts. The features extracted from the pathological images were used to develop statistical models that predict patients’ survival outcomes in ADC and SCC, respectively. Results We extracted 943 morphological features from pathological images of hematoxylin and eosin–stained tissue and identified morphological features that are significantly associated with prognosis in ADC and SCC, respectively. Statistical models based on these extracted features stratified NSCLC patients into high-risk and low-risk groups. The models were developed from training sets and validated in independent testing sets: a predicted high-risk group versus a predicted low-risk group (for patients with ADC: hazard ratio = 2.34, 95% confidence interval: 1.12–4.91, p = 0.024; for patients with SCC: hazard ratio = 2.22, 95% confidence interval: 1.15–4.27, p = 0.017) after adjustment for age, sex, smoking status, and pathologic tumor stage. Conclusions The results suggest that the quantitative morphological features of tumor pathological images predict prognosis in patients with lung cancer.

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“…1 Within NSCLC, adenocarcinoma (ADC) and squamous cell carcinoma (SCC) are the two major subtypes, with distinct prognoses and therapeutic remedies. 2,3 …”

Section: Introductionmentioning

confidence: 99%

Comprehensive Computational Pathological Image Analysis Predicts Lung Cancer Prognosis

Luo

Zang

Yang

et al. 2017

Journal of Thoracic Oncology

166

136

View full text Add to dashboard Cite

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“…Although the symptoms of ASC are similar to those of other histological subtypes of NSCLC (7), aggressive characteristics including early metastasis, invasiveness, rapid growth and poor prognosis have been recognized (8)(9)(10). Consequently, valuable prognostic factors are urgently needed for patients with ASC.…”

Section: Introductionmentioning

confidence: 99%

Prognostic value of combined platelet, fibrinogen, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with lung adenosquamous cancer

et al. 2017

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Abstract. The aim of the present study was to investigate the prognostic value of the combined platelet (PLT), fibrinogen (FBG), neutrophil to lymphocyte ratio (NLR) and platelet to lymphocyte ratio (PLR) (CO-NPF) for postoperative outcomes in patients with lung adenosquamous cancer (ASC). Test results from patients who presented at The Cancer Institute and Hospital of Tianjin Medical University between January 2005 and December 2013 were retrospectively reviewed. CO-NPF was scored between 0 and 4 according to increased PLT, FBG, NLR and PLR prior to being split into two groups based on the presence (≥2) or absence (<2) of the combination of increased inflammatory indexes. In total, data from 134 patients with ASC were reviewed for the present study. Multivariate analysis identified that increased CO-NPF (P= 0.001 and P<0.001, respectively), PLR (P=0.011 and P=0.001, respectively) and FBG (P=0.001 and P<0.001, respectively) were independently associated with shorter disease-free survival (DFS) and overall survival (OS). NLR (P=0.006) and PLT (P=0.001) were independent prognostic factors for OS. The area under the receiver operating characteristic curves of CO-NPF (area under the curve, 0.652, P= 0.008, 95% confidence interval, 0.551-0.752) was increased compared with NLR, PLR, PLT and FBG individually, suggesting that CO-NPF has greater predictive value. CO-NPF was significantly and independently associated with shorter DFS and OS, and had greater predictive value compared with NLR, PLR, PLT and FBG in patients with ASC who underwent surgery.

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“…ASC accounts for 0.4% to 4% of all lung cancers and thus is considered a relatively rare histologic subtype. ASC is substantially more aggressive than AC and SCC 2–8 . A previous study has shown that the 3‐ and 5‐year survival rates of patients with stage I ASC were similar to those of patients with stage IIIA AC or SCC 2 …”

Section: Introductionmentioning

confidence: 98%

Development and validation of a nomogram for predicting cancer‐specific survival of surgical resected stage I‐II adenosquamous carcinoma of the lung

Wang

Yang

et al. 2020

Journal of Surgical Oncology

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Objectives Primary lung adenosquamous carcinoma (ASC) is a rare cancer subtype and has a poor prognosis. The prognostic factors for resected early‐stage ASC remain unclear. We aimed to develop a nomogram to predict lung cancer‐specific survival (LCSS) of patients undergoing surgical resection for stage I‐II ASC. Methods Data of patients undergoing resection for stage I‐II ASC and diagnosed between 2004‐2015 were identified from the Surveillance, Epidemiology, and End Results (SEER) database. All the included patients were randomized at a 7:3 ratio into a training and a validation cohort. We selected and integrated significant prognostic factors based on competing for risk regression to build a nomogram. The performance of the nomogram was evaluated using Harrell's concordance index (C‐index) and calibration plots. Results A total of 988 patients (530 men and 458 women) undergoing surgical resection for stage I‐II ASC were identified and randomized into a training (692, 70%) cohort and a validation cohort (296, 30%). The baseline characteristics were similar in the training and validation cohorts. Age, T stage, N stage, and the number of examined lymph nodes were independent prognostic factors for LCSS and were used in the nomogram. The calibration plots showed that the 3‐ and 5‐year LCSS probabilities were consistent between the nomogram prediction and the actual observation. The C‐index of the nomogram was 0.671 (95%CI: 0.618‐0.724) and 0.635 (95%CI: 0.557‐0.713) in the training cohort and validation cohort, respectively. We developed a risk classification system based on the nomogram to stratify patients into high‐ and low‐risk of cancer‐specific death groups. Patients with a similar risk shared similar prognostic prediction regardless of the stage category and patients with the same risk shared similar prognoses despite the different stage category. Conclusions We developed a competing risk nomogram to reliably predict cancer‐specific survival of patients undergoing surgical resection for stage I‐II ASC. The nomogram might be a useful tool to identify patients undergoing surgical resection for ASC who could be suitable candidates for adjuvant chemotherapy.

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Adenosquamous carcinoma of the lung: surgical results as compared with squamous cell and adenocarcinoma cases

Abstract: ASC of the lung is more aggressive than AC and SC. The decreased survival of patients with ASC as compared with either of those single histology tumors suggests the need for a clinical trial of adjuvant chemotherapy that includes early-stage patients.

Cited by 75 publications

References 13 publications

Comprehensive Computational Pathological Image Analysis Predicts Lung Cancer Prognosis

Comprehensive Computational Pathological Image Analysis Predicts Lung Cancer Prognosis

Prognostic value of combined platelet, fibrinogen, neutrophil to lymphocyte ratio and platelet to lymphocyte ratio in patients with lung adenosquamous cancer

Development and validation of a nomogram for predicting cancer‐specific survival of surgical resected stage I‐II adenosquamous carcinoma of the lung

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