Endobronchial Mucosa Invasion Predicts Survival in Patients with Small Cell Lung Cancer

Abstract

BackgroundCurrent staging system for small cell lung cancer (SCLC) categorizes patients into limited- or extensive-stage disease groups according to anatomical localizations. Even so, a wide-range of survival times has been observed among patients in the same staging system. This study aimed to identify whether endobronchial mucosa invasion is an independent predictor for poor survival in patients with SCLC, and to compare the survival time between patients with and without endobronchial mucosa invasion.MethodsWe studied 432 consecutive patients with SCLC based on histological examination of biopsy specimens or on fine-needle aspiration cytology, and received computed tomography and bone scan for staging. All the enrolled patients were assessed for endobronchial mucosa invasion by bronchoscopic and histological examination. Survival days were compared between patients with or without endobronchial mucosa invasion and the predictors of decreased survival days were investigated.Results84% (364/432) of SCLC patients had endobronchial mucosal invasion by cancer cells at initial diagnosis. Endobronchial mucosal involvement (Hazard ratio [HR], 2.01; 95% Confidence Interval [CI], 1.30–3.10), age (HR, 1.04; 95% CI, 1.03–1.06), and extensive stage (HR, 1.39; 95% CI, 1.06–1.84) were independent contributing factors for shorter survival time, while received chemotherapy (HR, 0.32; 95% CI, 0.25–0.42) was an independent contributing factor better outcome. The survival days of SCLC patients with endobronchial involvement were markedly decreased compared with patients without (median 145 vs. 290, p<0.0001). Among SCLC patients of either limited (median 180 vs. 460, p<0.0001) or extensive (median 125 vs. 207, p<0.0001) stages, the median survival duration for patients with endobronchial mucosal invasion was shorter than those with intact endobronchial mucosa, respectively.ConclusionEndobronchial mucosal involvement is an independent prognostic factor for SCLC patients and associated with decreased survival days.

A lower level of forced expiratory volume in one second predicts the poor prognosis of small cell lung cancer

“…Nonetheless, this was a multicenter study with a large sample size, which allowed us to have greater power to detect the relationship between impairment of lung function and prognosis in SCLC patients, and the risk of poorer clinical outcomes in more homogeneous subgroups. Second, the scope of this study was limited to PFT and did not address the role of emphysema or an endobronchial lesion in determining the poor clinical outcomes of SCLC (25,29). Third, additional treatments for COPD such as inhalers or anti-inflammatory agents were not considered.…”

Diffusion-Perfusion Mismatch in Single Subcortical Infarction: A Predictor of Early Neurological Deterioration and Poor Functional Outcome

“…We entered baseline predictors into multivariable models if the p value from the univariable model was less than 0.1 [32]. Results are reported as odds ratios (OR) with 95% confidence intervals (CI).…”

Pulmonary consolidation - when it's more than just infection

“…Endobronchial invasion implies an invasive component. The presence of invasion with concomitant consolidation should raise suspicion for malignancy [4] Case courtesy of Sally Ayesa The presence of visceral or skeletal metastatic disease raises a red flag for a primary cancer. Sites to pay close attention to for metastatic disease include the bones (green arrow), liver, adrenal glands (orange arrow) and brain.…”