Small-cell carcinoma of the lung—survival according to histologic subtype: A veterans administration lung group study

Abstract

Six-hundred-twenty cases of small-cell carcinoma of the lung entered into the Veterans Administration Lung Group protocols 9-15 were retrospectively subdivided into histologic subtype, as proposed by the WHO (1977). Medium survival was greater for subtype No. 21 (lymphocyte-like) than for subtype No. 22 (intermediate) (17.2 vs. 12.6 weeks; P = .005). Patients with extensive disease survived longer with subtype No. 21 than subtype No. 22 (14.5 vs. 10.9 weeks; P = .026). However, no median survival difference was seen with limited disease. Survival for subtype 21 was greater than No. 22 (P = .016) for patients with poor initial performance status (IPS; Karnofsky 70 or less); for ambulatory patients (IPS 80-100) a survival advantage was seen for subtype No. 21 compared with No. 22, but did not quite reach statistical significance (P = .09). Survival in subtype No. 21 was better than in subtype No. 22 (24.3 vs. 14.7 weeks; P = .001) when no weight loss (less than 10 pounds over the six-month period prior to therapy) was documented. However, with weight loss (greater than 10 pounds) survival in each subtype was similar.

How reliable is the diagnosis of lung cancer using small biopsy specimens? Report of a UKCCCR Lung Cancer Working Party.

“…The numbering of these criteria is used in the same way throughout this paper. The criteria are grouped together because of assumed associations with particular tumour types: criteria 1-4 with squamous carcinoma, [5][6][7][8][9][10][11][12][13] with small cell carcinoma, and 14-18 with adenocarcinoma. Definitions of the diagnostic criteria and diagnostic categories are listed in appendix 4. Eighty biopsy specimens of lung cancer were retrieved from the departmental files of the participating pathologists; contemporaneous cytological specimens and resection specimens were also available.…”

Histopathologic classification of small cell carcinoma of the lung. Comments based on an interobserver examination

“…Using the presence of significant host response and/or the presence of large cell carcinoma as a criterion for the diagnosis of the intermediate subtype of SCCL, a longer survival for patients with oat-cell carcinoma was reported in a large study of 620 patients with SCCL treated with chemotherapy in the study by VALG. 6 It is concluded from the current study that a high degree of unanimity among different panelists is possible in the diagnosis of SCCL. Almost 10% of small cell tumors provoke significant problems in the light microscopic interpretation, particularly tumors demonstrating transition to large cell carcinoma, and those with squamous cell differentiation and/or glandular components.…”

“…*-lo Neither was any difference in survival between the morphologic subtypes reported from studies performed at the National Cancer Institute, USA, where a modified W H O classification was Members of the Veterans Administration Lung Group Study (VALG) have reported that patients with the "oat-cell" subtype had a longer survival after chemotherapy than patients with the "intermediate" cell type. 6 After 14 years' experience with the first classification, a revised WHO classification of lung tumors was recommended in 198 1 . *' SCCL was divided into three subtypes: "oat-cell,'' "intermediate," and "combined SCCL."…”

A Deep Model for Lung Cancer Type Identification by Densely Connected Convolutional Networks and Adaptive Boosting

“…Currently, lung cancer can be divided into two types according to the degree of differentiation and morphological characteristics: small cell lung cancer (SCLC) and non-small cell lung cancer (NSCLC). NSCLC includes three subtypes: squamous cell carcinoma, adenocarcinoma and large cell carcinoma [9]- [13]. Timely diagnosis of lung cancer type is of great clinical significance to help doctors develop effective treatment programs and improve patients' survival time and quality of life.…”