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open-access-imgOpen AccessIntegrated evaluation of clinical, pathological and radiological prognostic factors in squamous cell carcinoma of the lung
Author(s)
Kyo-Won Gu,
Ho Yun Lee,
Kyung Soo Lee,
Joon Young Choi,
Sook Young Woo,
Insuk Sohn,
Hojoong Kim,
Yong Choi,
Jhingook Kim,
Byung-Hoon Min,
Young Mog Shim
Publication year2019
Publication title
plos one
Resource typeJournals
PublisherPublic Library of Science
Objective Little 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 methods Radiologic, 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. Results The 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. Conclusions CT-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.
Subject(s)biology , confidence interval , gastroenterology , hazard ratio , lung , lung cancer , medicine , multivariate analysis , oncology , paleontology , pathological , pneumonitis , proportional hazards model , radiology , stage (stratigraphy) , univariate analysis
Language(s)English
SCImago Journal Rank0.99
H-Index332
ISSN1932-6203
DOI10.1371/journal.pone.0223298

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