Integrated evaluation of clinical, pathological and radiological prognostic factors in squamous cell carcinoma of the lung

Autoři: Kyowon Gu aff001;  Ho Yun Lee aff001;  Kyungjong Lee aff002;  Joon Young Choi aff003;  Sook Young Woo aff004;  Insuk Sohn aff004;  Hong Kwan Kim aff005;  Yong Soo Choi aff005;  Jhingook Kim aff005;  Jae Ill Zo aff005;  Young Mog Shim aff005
Působiště autorů: Department of Radiology and Center for Imaging Science, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea aff001;  Division of Pulmonary and Critical Care Medicine, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea aff002;  Department of Nuclear Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea aff003;  Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Seoul, Korea aff004;  Department of Thoracic and Cardiovascular Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea aff005
Vyšlo v časopise: PLoS ONE 14(10)
Kategorie: Research Article



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.


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.


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.

Klíčová slova:

Computed axial tomography – Lung and intrathoracic tumors – Metastasis – Necrosis – Secondary lung tumors – Surgical and invasive medical procedures – Surgical oncology – Squamous cell lung carcinoma


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2019 Číslo 10
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