Prognostic Factors Based on Clinicopathological Data Among the Patients with Resected Peripheral Squamous Cell Carcinomas of the Lung

Abstract

Introduction: Although the incidence of peripheral squamous cell carcinomas (p-SqCCs) of the lung has increased over recent years, clinicopathological factors influencing prognosis of resected p-SqCCs remain unclear. Methods: We examined 280 patients who underwent complete resection of SqCCs and analyzed the clinicopathological features in relation to their overall survival (OS) and recurrence-free survival (RFS) according to the primary location. Results: Multivariate analysis of all stages of p-SqCCs patients revealed that high serum squamous cell carcinoma antigen (SCC) level (OS; p < 0.01, RFS; p < 0.01), vascular invasion (OS; p < 0.01, RFS; p < 0.01), pleural invasion (OS; p = 0.03, RFS; p = 0.01), nodal metastasis (OS; p = 0.02) and complication with lung disease (OS; p < 0.01) were independently unfavorable prognostic factors. Among stage I p-SqCCs patients, high serum SCC level (OS; p < 0.01, RFS; p < 0.01), vascular invasion (RFS; p < 0.01) and pleural invasion (RFS; p = 0.01) were also strongly correlated with poor prognosis independently. When we reevaluated the survival rate, T1 p-SqCCs with high serum SCC level or vascular invasion can be upgraded to T2a. Patients with stage IB had a significantly poorer prognosis than stage IA (5-year RFS; 61.4 % versus 76.6 %, p < 0.05). Conclusion: High serum SCC level, pleural and vascular invasions were independent poor prognostic factors for completely resected p-SqCCs. T1 p-SqCCs with high serum SCC level or vascular invasion should be upgraded to T2a, which accurately reflect survival status among patients with p-SqCCs.

Prognostic Model for Resected Squamous Cell Lung Cancer: External Multicenter Validation and Propensity Score Analysis exploring the Impact of Adjuvant and Neoadjuvant Treatment

“…1). Although several prognostic factors included in the nomogram have already been correlated with survival outcomes in lung cancer, [15][16][17] our integrated index represents one of the first prognostic nomograms built selectively for a population of patients affected by lung cancer of squamous histological subtype. A similar study performed in resected NSCLC (regardless of the histological subtype) by Liang et al contributes to support the reliability of a prognostic model based on clinicopathological predictors.…”

Restrictive ventilatory impairment is associated with poor outcome in patients with cT1aN0M0 peripheral squamous cell carcinoma of the lung

“…Increased serum levels of tumor markers can be indicators of worse outcomes. In the published literature, high serum levels of CEA (29) and SCC-Ag (9,30) have been found to indicate poor outcomes in patients with early-stage lung SqCC. We also found that a high serum SCC-Ag level was an independent risk factor for recurrence after anatomical resection; however, a major limitation of this study was that the serum SCC-Ag level was only measured in 150 (67.6%) of all 222 study patients, and 115 (66.5%) of 173 patients who underwent anatomical resection.…”

“…To date, positive tumor margins, visceral pleural involvement, lymphatic invasion, vascular invasion, and tumor grade have been identified as risk factors for local recurrence (33,35). In patients with SqCC of the lung, visceral pleural invasion (30), lymphatic invasion (36) and vascular invasion (9,30) have been found to be risk factors for poor outcomes in several studies that did not assess the effects of pulmonary function parameters in detail. In our study, visceral pleural invasion and lymphatic invasion were not found to be significantly prognostic, although they tended to show worse outcomes.…”

Clinicopathological features of small‑sized peripheral squamous cell lung cancer

“…We included all patients with tumors located within the outer third of the lung field on preoperative computed tomography, which were ≤2 cm in pathological size. Because our study mainly focuses on pathological characteristics, we used more accurate pathological size in this study rather than clinical size like other reports (12,14). Because the aim of this study is to investigate the malignant potential of tumor itself, and not the prognostic value, we included all surgical procedures; i.e., lobectomy, segmentectomy, and wedge resection.…”