Differences in postoperative prognosis between early-stage lung adenocarcinoma and squamous cell carcinoma

Yu Izaki

Mimae Takahiro

Kagimoto Atsushi

Handa Yoshinori

Tsutani Yasuhiro

Miyata Yoshihiro

Okada Morihito

Takeshima Yukio

Japanese Journal of Clinical Oncology

Background
Although prognosis and treatments differ between small-cell- and nonsmall-cell carcinoma, comparisons of the histological types of NSCLC are uncommon. Thus, we investigated the oncological factors associated with the prognosis of early-stage adenocarcinoma and squamous cell carcinoma.
Methods
We retrospectively compared the clinicopathological backgrounds and postoperative outcomes of patients diagnosed with pathological stage I–IIA adenocarcinoma and squamous cell carcinoma primary lung cancer completely resected at our department from January 2007 to December 2017. Multivariable Cox regression analysis for overall survival and recurrence-free survival was performed.
Results
The median follow-up duration was 55.2 months. The cohort consisted of 532 adenocarcinoma and 96 squamous cell carcinoma patients. A significant difference in survival was observed between the two groups, with a 5-year overall survival rate of 90% (95% confidence interval 86–92%) for adenocarcinoma and 77% (95% CI 66–85%) for squamous cell carcinoma (P < 0.01) patients. Squamous cell carcinoma patients had worse outcomes compared to adenocarcinoma patients in stage IA disease, but there were no significant differences between the two groups in stage IB or IIA disease. In multivariate analysis, invasion diameter was associated with overall survival in adenocarcinoma (hazard ratio 1.76, 95% confidence interval 1.36–2.28), but there was no such association in squamous cell carcinoma (hazard ratio 0.73, 95% confidence interval 0.45–1.14).
Conclusions
The importance of tumor invasion diameter in postoperative outcomes was different between adenocarcinoma and squamous cell carcinoma. Thus, it is important to consider that nonsmall-cell carcinoma may have different prognoses depending on the histological type, even for the same stage.

surgery

prognosis

lung cancer

adenocarcinoma

squamous cell carcinoma

eng

Oxford

This is a pre-copyedited, author-produced version of an article accepted for publication in Japanese Journal of Clinical Oncology following peer review. The version of record Volume 54, Issue 7, July 2024, Pages 813–821 is available online at: https://doi.org/10.1093/jjco/hyae049.

This is not the published version. Please cite only the published version.

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[DOI] https://doi.org/10.1093/jjco/hyae049 isVersionOf