Clinicopathological characteristics and prognosis of patients with adenosquamous lung carcinoma

Abstract

This study was aimed to characterize clinicopathological features and prognosis of patients with adenosquamous lung carcinoma (ASC). Among the 2531 patients with lung cancer who underwent surgery between January 2000 and June 2012 in our hospital, 59 were histologically diagnosed as having ASC. The clinicopathological features and follow-up data of ASC patients were collected and analyzed statistically. Superior lobectomy was accomplished in 40 patients, middle and inferior lobectomy in 3, lobectomy plus partial resection of contralateral lung in 5, partial lung resection in 4, and pneumonectomy in 7. Moreover, 22 cases were found to be adenocarcinoma-predominant, and 18 to be squamous cell carcinoma-predominant. The median survival time was 13.6 months, and the 1-, 3-, and 5-year survival rates were 59.9%, 36.4% and 31.2%, respectively. Of the 52 cases with tissue specimens available, 11 had an EGFR mutation (21.2%) and 2 had a KRAS mutation (3.8%). Multivariate analysis showed that histology subtype, pleural invasion, TNM stage, and postoperative treatment were all independent prognostic factors. The data from the current study demonstrated that SCC-predominant histology represents a better prognosis of ASC. Histology subtype, pleural invasion, TNM stage, and postoperative treatment are independent prognostic factors for ASC and adjuvant therapy may help control the disease.

Keywords

lung adenosquamous carcinoma / histology / clinicopathological feature / prognosis / EGFR and KRAS mutation

References

[1] FerlayJ, ShinHR, BrayF, et al. . Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer, 2010, 127(12): 2893-2917 PMID: 21351269

[2] FilossoPL, RuffiniE, AsioliS, et al. . Adenosquamous lung carcinomas: a histologic subtype with poor prognosis. Lung Cancer, 2011, 74(1): 25-29 PMID: 21371773

[3] LeeY, ChungJH, KimSE, et al. . Adenosquamous carcinoma of the lung: CT, FDG PET, and clinicopathologic findings. Clin Nucl Med, 2014, 39(2): 107-112 PMID: 23751831

[4] MaedaH, MatsumuraA, KawabataT, et al. . Adenosquamous carcinoma of the lung: surgical results as compared with squamous cell and adenocarcinoma cases. Eur J Cardiothorac Surg, 2012, 41(2): 357-361 PMID: 21737295

[5] TochigiN, DacicS, NikiforovaM, et al. . Adenosquamous carcinoma of the lung: a microdissection study of KRAS and EGFR mutational and amplification status in a western patient population. Am J Clin Pathol, 2011, 135(5): 783-789 PMID: 21502435

[6] MordantP, GrandB, CazesA, et al. . Adenosquamous carcinoma of the lung: surgical management, pathologic characteristics, and prognostic implications. Ann Thorac Surg, 2013, 95(4): 1189-1195 PMID: 23473060

[7] YuJQ, YangZG, AustinJH, et al. . Adenosquamous carcinoma of the lung: CT-pathological correlation. Clin Radiol, 2005, 60(3): 364-369 PMID: 15710140

[8] CookeDT, NguyenDV, YangY, et al. . Survival comparison of adenosquamous, squamous cell, and adenocarcinoma of the lung after lobectomy. Ann Thorac Surg, 2010, 90(3): 943-948 PMID: 20732522

[9] FitzgibbonsPL, KernWH. Adenosquamous carcinoma of the lung: a clinical and pathologic study of seven cases. Hum Pathol, 1985, 16(5): 463-466 PMID: 3988274

[10] GawrychowskiJ, BrulinskiK, MalinowskiE, et al. . Prognosis and survival after radical resection of primary adenosquamous lung carcinoma. Eur J Cardiothorac Surg, 2005, 27(4): 686-692 PMID: 15784375

[11] IshidaT, KanekoS, YokoyamaH, et al. . Adenosquamous carcinoma of the lung. Clinicopathologic and immunohistochemical features. Am J Clin Pathol, 1992, 97(5): 678-685 PMID: 1575214

[12] KamiyoshiharaM, HiraiT, KawashimaO, et al. . A clinicopathologic study of the resected cases of adenosquamous carcinoma of the lung. Oncol Rep, 1998, 5(4): 861-865 PMID: 9625833

[13] KanazawaH, EbinaM, Ino-OkaN, et al. . Transition from squamous cell carcinoma to adenocarcinoma in adenosquamous carcinoma of the lung. Am J Pathol, 2000, 156(4): 1289-1298 PMCID: 1876884 PMID: 10751354

[14] NakagawaK, YasumituT, FukuharaK, et al. . Poor prognosis after lung resection for patients with adenosquamous carcinoma of the lung. Ann Thorac Surg, 2003, 75(6): 1740-1744 PMID: 12822609

[15] NaunheimKS, TaylorJR, SkoseyC, et al. . Adenosquamous lung carcinoma: clinical characteristics, treatment, and prognosis. Ann Thorac Surg, 1987, 44(5): 462-466 PMID: 3675050

[16] ShimizuJ, OdaM, HayashiY, et al. . A clinicopathologic study of resected cases of adenosquamous carcinoma of the lung. Chest, 1996, 109(4): 989-994 PMID: 8635382

[17] ShimojiM, NakajimaT, YamataniC, et al. . A clinicopathological and immunohistological re-evaluation of adenosquamous carcinoma of the lung. Pathol Int, 2011, 61(12): 717-722 PMID: 22126378

[18] VincentMD. Optimizing the management of advanced non-small-cell lung cancer: a personal view. Curr Oncol, 2009, 16(4): 9-21 PMCID: 2722061 PMID: 19672420

[19] BastideK, UgolinN, LevaloisC, et al. . Are adenosquamous lung carcinomas a simple mix of adenocarcinomas and squamous cell carcinomas, or more complex at the molecular level. Lung Cancer, 2010, 68(1): 1-9 PMID: 20004040

[20] WatanabeY, TsutaK, KusumotoM, et al. . Clinicopathologic features and computed tomographic findings of 52 surgically resected adenosquamous carcinomas of the lung. Ann Thorac Surg, 2014, 97(1): 245-251 PMID: 24206962

[21] TravisWD, BrambillaE, Rami-PortaR, et al. . Visceral pleural invasion: pathologic criteria and use of elastic stains: proposal for the 7 of the TNM classification for lung cancer. J Thorac Oncol, 2008, 3(12): 1384-1390 PMID: 19057261

[22] TakamoriS, NoguchiM, MorinagaS, et al. . Clinicopathologic characteristics of adenosquamous carcinoma of the lung. Cancer, 1991, 67(3): 649-654 PMID: 1985759

[23] HsiaJY, ChenCY, HsuCP, et al. . Adenosquamous carcinoma of the lung. Surgical results compared with squamous cell and adenocarcinoma. Scand Cardiovasc J, 1999, 33(1): 29-32 PMID: 10093856

[24] RuffiniE, RenaO, OliaroA, et al. . Lung tumors with mixed histologic pattern. Clinico-pathologic characteristics and prognostic significance. Eur J Cardiothorac Surg, 2002, 22(5): 701-707 PMID: 12414033

[25] SridharKS, BounassiMJ, RaubWJr, et al. . Clinical features of adenosquamous lung carcinoma in 127 patients. Am Rev Respir Dis, 1990, 142(1): 19-23 PMID: 2368969

[26] CakirE, DemiragE, AydinM, et al. . Clinicopathologic features and prognostic significance of lung tumours with mixed histologic patterns. Acta Chir Belg, 2009, 109(4): 489-493 PMID: 19803261

[27] NihoS, YokoseT, KodamaT, et al. . Clonal analysis of adenosquamous carcinoma of the lung. Jpn J Cancer Res, 1999, 90(11): 1244-1247 PMID: 10622536

[28] RiquetM, AssouadJ, Le Pimpec-BarthesF, et al. . Adenosquamous carcinoma of the lung and visceral pleural invasion. Ann Thorac Surg, 2004, 78(4): 1511-1512 PMID: 15464536

[29] RiquetM, PerrotinC, Lang-LazdunskiL, et al. . Do patients with adenosquamous carcinoma of the lung need a more aggressive approach. J Thorac Cardiovasc Surg, 2001, 122(3): 618-619 PMID: 11547321

[30] ShiozawaT, IshiiG, GotoK, et al. . Clinicopathological characteristics of EGFR mutated adenosquamous carcinoma of the lung. Pathol Int, 2013, 63(2): 77-84 PMID: 23464964

[31] JiaXL, ChenG. EGFR and KRAS mutations in Chinese patients with adenosquamous carcinoma of the lung. Lung Cancer, 2011, 74(3): 396-400 PMID: 21592614

[32] KimYT, KimTY, LeeDS, et al. . Molecular changes of epidermal growth factor receptor (EGFR) and KRAS and their impact on the clinical outcomes in surgically resected adenocarcinoma of the lung. Lung Cancer, 2008, 59(1): 111-118 PMID: 17904685