Clinicopathological features of small‑sized peripheral squamous cell lung cancer

Abstract

Recent advances in imaging technology have enhanced the detection rate of small-sized peripheral lung cancers. The present study aimed to identify the clinicopathological differences between patients with small-sized peripheral squamous cell carcinoma (SCC) and adenocarcinoma (ADC). Patients with lung cancer who underwent radical surgical resection at Gunma University Hospital between July 2007 and October 2012 were retrospectively analyzed. Patients who exhibited small-sized peripheral tumors (pathological size, ≤2 cm) located within the outer-third of the lung field on preoperative computed tomography were enrolled in the present study. A total of 26 patients were diagnosed with SCC and 214 with ADC. The results revealed that patients with SCC exhibited higher rates of pleural invasion, vascular invasion and lymphatic invasion compared with ADC patients. Additionally, the rate of postoperative recurrence was higher in patients with SCC compared with ADC patients. Patients with ADC were subsequently into two groups: Solid ADCs (sADC) and non-solid ADCs (nsADC), which included pure ground glass nodules and part-solid ADCs. The results revealed that the incidence of pleural invasion, vascular invasion and lymphatic invasion, and the rate of postoperative recurrence in patients with sADCs were similar to those with SCC, but were also significantly higher when compared with nsADC patients. The present study concluded that patients with SCC and sADC may not be suitable candidates for sublobar resection, despite exhibiting small tumors that are located in the peripheral lung.

Lepidic growth component as a favorable prognostic factor in non–small cell lung cancer of ≤3 cm

“…However, the eighth edition of the TNM classification does not distinguish between histologic types for the pathologic stage of NSCLC 26 . In addition, lung adenocarcinoma without GGO has a similar prognosis to squamous cell carcinoma 6,11 . In this study, the histologic type was not a significant prognostic factor in the multivariate analysis that compared the effect of LGC and histologic type on the prognosis of NSCLC, suggesting that the difference in prognosis between adenocarcinoma without an LGC and NSCLC can be attributed to adenocarcinoma.…”

“…One of the limitations of using adenocarcinoma for prognostication in previous studies is that the prognosis was thought to differ depending on the histologic type. Some studies have shown that adenocarcinomas have a better prognosis than squamous cell carcinomas 6,11,23 . In contrast, adenocarcinoma without a GGO component has an equivalent risk of postoperative recurrence compared with squamous cell carcinoma 6 .…”

“…The development of imaging technology, such as computed tomography (CT), has increased the identification and surgical treatment of small‐sized non–small cell lung cancer (NSCLC) in recent years. 1 Previous studies have reported that small‐sized NSCLC with ground‐glass opacity (GGO) is non‐invasive with little vessel invasion or lymph node metastasis and has an improved prognosis compared to tumors without GGO 2 , 3 , 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ; this is because the GGO component is usually pathologically equivalent to a lepidic growth component (LGC). 2 , 12 , 13 , 14 , 15 Therefore, some researchers have suggested that the stage of NSCLC can be determined by the GGO component.…”

A Grading System for Invasive Pulmonary Adenocarcinoma: A Proposal From the International Association for the Study of Lung Cancer Pathology Committee

“…Although lymphatic invasion was not evaluated in this study, it has been reported that it is associated with high-grade patterns. 39,40 It is also important to note that the proposed grading system has not been validated in variants of adenocarcinoma, including invasive mucinous adenocarcinoma. Further studies are necessary to evaluate the applicability and performance of the model in these special tumors.…”

Establishment and Validation of a Predictive Nomogram for Postoperative Survival of Stage I Non-Small Cell Lung Cancer

“…The main prognosis elements for stage I NSCLC, as reported in previous studies, included age, sex, smoking status, visceral pleural invasion, type of resection, histology subtype, and differentiation. [4][5][6] And there is no consensus on whether postoperative adjuvant therapy is beneficial for stage I NSCLC.…”