Integrated evaluation of clinical, pathological and radiological prognostic factors in squamous cell carcinoma of the lung

Abstract

ObjectiveLittle is known about prognostic factors for lung squamous cell carcinoma (SCC). We aimed to explore radiologic and clinical factors affecting prognosis and to compare the prognosis of both central and peripheral lung SCCs.Materials and methodsRadiologic, clinical, and pathologic profiles of surgically confirmed SCCs from 382 patients were retrospectively reviewed. Tumor location, enhancement, necrosis, the presence of obstructive pneumonitis/atelectasis and underlying lung disease were evaluated on chest CT examination. Age, pulmonary function, tumor marker, and cancer stage were also assessed. Univariate and multivariate Cox regression analyses were performed to identify any correlation to overall survival (OS) and disease-free survival (DFS). Hazard rate estimation and competing risk analysis were done to evaluate recurrence pattern.ResultsThe median follow-up period was 56.2 months. Tumors were located centrally in 230 patients (60.2%) and peripherally in 152 patients (39.8%). Age (p = 0.002, hazard ratio [HR] 1.03, 95% confidence interval [CI] = [1.01, 1.06]) and interstitial lung abnormalities (ILAs) (p<0.001, HR 5.41, 95% CI = [3.08, 9.52]) were associated with poor OS on multivariate analysis. ILAs also had a strong association to DFS (p<0.001, HR 4.25, 95% CI = [3.08, 9.52]). Central cancers had two peaks of local recurrence development at 15 and 60 months after surgery, and peripheral tumors showed rising curves for metastasis development at 60 months.ConclusionsCT-determined ILAs are a strong biomarker predicting poor outcome. Prognosis may not vary according to tumor location, but the two groups exhibited different recurrence patterns.

A prognostic model for elderly patients with squamous non-small cell lung cancer: a population-based study

“…This nomogram included nine variables: age, sex, race, marital status, tumor site, AJCC stage, surgery, radiation and chemotherapy, which was capable of making more accurate evaluations and predictions in elderly SCC patients compared to the traditional AJCC staging system both in the training and validation groups. The previous study reported that SCC was the predominant NSCLC histologic subtype in men [9,22]. We also found that elderly SCC cases tended to be male sex in our investigation.…”

“…With the development of molecularly targeted therapy, although it has revolutionized the treatment of patients with EGFR mutation-positive NSCLC, the incidence of this activating mutation of EGFR is lower in SCC patients than in AC patients, which limits the effect of clinical treatment for SCC cases. Moreover, SCC patients tend to be older than those with AC [ 22 ]. Ultimately, the prognosis for gerontal patients with advanced NSCLC is poorer for those with SCC than for those with AC [ 6 , 23 ].…”

“…The previous study reported that SCC was the predominant NSCLC histologic subtype in men [ 9 , 22 ]. We also found that elderly SCC cases tended to be male sex in our investigation.…”

“…The independent prognostic factors in our study were similar to those identified in several previous researches. Gu et al has discovered that increasing age and histopathologic N2 disease can be correlated with poor LCSS for lung squamous cell carcinoma patients [ 22 ]. A study by Ryota et al has identified that increased tumor size, lymph node metastasis, lymphatic invasion, poor tissue differentiation and INFc(−) can be significantly associated with increased mortality of lung squamous cell carcinoma [ 24 ].…”

Radiological and Morphological Patterns of Idiopathic Pulmonary Fibrosis From the Earliest Manifestations to the Outcome

“…Многие авторы подчеркивают, что у пациентов с МИИ достоверно чаще развивается РДС, а также рак легкого и осложнения разных вариантов его лечения (оперативного, лучевой, химиотерапии) [15][16][17][18][19][20][21][22].…”