Cavitating squamous cell lung carcinoma-distinct entity or not?

Pentheroudakis, G.; Kostadima, Lida; Fountzilas, George; Kalogera‐Fountzila, Anna; Klouvas, George; Kalofonos, C.; Pavlidis, Nicholas

doi:10.1016/j.lungcan.2004.02.013

Cited by 32 publications

(8 citation statements)

References 14 publications

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“…In a study of squamous cell lung carcinoma that underwent radical surgery, cavitation was poor prognostic factor (32). However, Pentheroudakis et al (33) found no definite evidence of inferior survival of cavitating squamous cell carcinoma than that of solid squamous cell carcinoma in the lung.…”

Section: Discussionmentioning

confidence: 97%

Imaging Characteristics of Stage I Non-Small Cell Lung Cancer on CT and FDG-PET: Relationship with Epidermal Growth Factor Receptor Protein Expression Status and Survival

Lee

Kim

et al. 2013

Korean J Radiol

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ObjectiveTo identify CT and FDG-PET features associated with epidermal growth factor receptor (EGFR) protein overexpression, and to evaluate whether imaging features and EGFR-overexpression can help predict clinical outcome.Materials and MethodsIn 214 patients (M : F = 129 : 85; mean age, 63.2) who underwent curative resection of stage I non-small cell lung cancer, EGFR protein expression status was determined through immunohistochemical analysis. Imaging characteristics on CT and FDG-PET was assessed in relation to EGFR-overexpression. Imaging features and EGFR-overexpression were also evaluated for clinical outcome by using the Cox proportional hazards model.ResultsEGFR-overexpression was found in 51 patients (23.8%). It was significantly more frequent in tumors with an SUVmax > 5.0 (p < 0.0001), diameter > 2.43 cm (p < 0.0001), and with ground glass opacity ≤ 50% (p = 0.0073). SUVmax > 5.0 (OR, 3.113; 95% CI, 1.375-7.049; p = 0.006) and diameter > 2.43 cm (OR, 2.799; 95% CI, 1.285-6.095; p = 0.010) were independent predictors of EGFR overexpression. Multivariate analysis showed that SUVmax > 4.0 (hazard ratio, 10.660; 95% CI, 1.370-82.966; p = 0.024), and the presence of cavitation within a tumor (hazard ratio, 3.122; 95% CI, 1.143-8.532; p = 0.026) were factors associated with poor prognosis.ConclusionEGFR-overexpression is associated with high SUVmax, large tumor diameter, and small GGO proportion. CT and FDG-PET findings, which are closely related to EGFR overexpression, can be valuable in the prediction of clinical outcome.

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Section: Discussionmentioning

confidence: 97%

Imaging Characteristics of Stage I Non-Small Cell Lung Cancer on CT and FDG-PET: Relationship with Epidermal Growth Factor Receptor Protein Expression Status and Survival

Lee

Kim

et al. 2013

Korean J Radiol

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“…[ 19 ] Although this does not necessarily result in a higher stage for patients with NSCLC-c as shown in our study cohort and some previous reports,[ 13 14 ] one report did indicate that NSCLC-c is associated with locally advanced and metastatic disease compared with NSCLC-nc. [ 15 ] Our findings also indicate that neither the primary size nor cell type (at least for squamous cell carcinoma and adenocarcinoma) result in a worse staging and survival.…”

Section: Discussionmentioning

confidence: 66%

“…[ 3 ] More than 40% of the lung primaries originated in the upper lobe, 25/40 (62.5%) for NSCLC-c and 24/40 (60%) for NSCLC-nc, which is independent of the stage at which they are diagnosed. [ 10 15 ]…”

Section: Discussionmentioning

confidence: 99%

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Are there radiographic, metabolic, and prognostic differences between cavitary and noncavitary nonsmall cell lung carcinoma? A retrospective fluorodeoxyglucose positron emission tomography/computed tomography study

et al. 2016

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AIMS:The prognosis of nonsmall cell lung cancer with cavitation (NSCLC-c) is not well-known. We compared the positron emission tomography/computed tomography (PET/CT) findings and survival data of patients with NSCLC-c patients with those without cavitation (NSCLC-nc).METHODS:Between 7/2004 and 6/2007, cavitary lung lesions were identified in 46/248 patients undergoing fluorodeoxyglucose (FDG) PET/CT for lung nodule characterization or lung cancer staging. Within the same period, 40 of 202 patients with NSCLC-nc were randomly selected for comparison. The primary was assessed by location, size, cell type, and standardized uptake value (SUV). Disease stage was determined according to American Joint Committee on Cancer guidelines for lung cancer. Kaplan–Meier method was used for survival analysis and Cox regression to assess the effect of clinical and imaging variables on survival.RESULTS:NSCLC-c was found in 87% of patients that had a cavitary lung lesion at PET/CT. Squamous cell carcinoma, primary size and primary-to-liver SUV ratio differed significantly between NSCLC-c and NSCLC-nc, whereas age, gender, primary location, primary SUV, type of treatment, and disease stage did not. Median survival and overall 5-year survival were 19 months and 24% for NSCLC-c, and 31 months and 31% for NSCLC-nc, P = 0.23. Disease stage was the only predictor of survival.CONCLUSION:Cavitary lung lesions in patients undergoing FDG PET/CT harbor a significant risk for cancer. NSCLC-c is associated with squamous cell carcinoma, larger size, and greater FDG metabolism compared with NSCLC-nc, although these variables may not be predictive of survival. Nonetheless, PET/CT contributes to accurate staging and has an indirect impact on prognosis.

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“…Lung cavitation was defined as the presence of an abnormal hollow space, either fluid filled or vacant within lung parenchyma 5. The circled region of interest on target lesions and tumor density were assessed by measuring Hounsfield units (HU) on the CT scan at baseline and at the time of evaluation.…”

Section: Methodsmentioning

confidence: 99%

Significance of different response evaluation criteria in predicting progression‐free survival of lung cancer with certain imaging characteristics

et al. 2016

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BackgroundCertain radiographic signs of a treatment response, such as cavitation, changes in density, or tumor change along a short axis, are not considered by Response Evaluation Criteria in Solid Tumors (RECIST). This study evaluates what additional prognostic information can be obtained by including these criteria in tumor assessment.MethodsData of 105 patients were included. Tumor cavitation was observed in 51 patients at baseline. An additional 23 patients developed tumor cavitation during treatment. A change in tumor density was the only radiographic treatment response observed in 22 patients. The only measureable treatment response in nine patients was a decrease along the short axis size of the tumor. Tumor response was assessed using various criteria.ResultsIn patients with basic tumor cavitation, RECIST1.1 scores accurately predicted differences in progression‐free survival (PFS; P = 0.076) while modified (m) RECIST did not (P = 0.550). mRECIST detected a significant difference between PFS in patients with post‐therapeutic cavitation with different responses, but no significant difference using RECIST1.1 (P = 0.004 vs. P = 0.477). In patients with only tumor density changes, there was no significant difference in PFS when either RECIST1.1 or density criteria were used (P = 0.419). In patients with a change in size along the tumor's short axis, short axis criteria could predict significant difference in PFS (P = 0.004).Conclusions RECIST1.1 provides the best assessment of tumor response and prediction of PFS in patients with basic tumor cavitation. mRECIST provides better PFS prognostic information in patients with post‐therapeutic cavitation. Short axis criteria provides better PFS prognostic information in patients with changes in the short axis of tumor diameter. Changes in tumor density were not a useful prognostic sign.

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Cavitating squamous cell lung carcinoma-distinct entity or not?

Cited by 32 publications

References 14 publications

Imaging Characteristics of Stage I Non-Small Cell Lung Cancer on CT and FDG-PET: Relationship with Epidermal Growth Factor Receptor Protein Expression Status and Survival

Imaging Characteristics of Stage I Non-Small Cell Lung Cancer on CT and FDG-PET: Relationship with Epidermal Growth Factor Receptor Protein Expression Status and Survival

Are there radiographic, metabolic, and prognostic differences between cavitary and noncavitary nonsmall cell lung carcinoma? A retrospective fluorodeoxyglucose positron emission tomography/computed tomography study

Significance of different response evaluation criteria in predicting progression‐free survival of lung cancer with certain imaging characteristics

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