Clinical outcomes of primary adenosquamous carcinoma of the lung treated by surgery

doi:10.3877/cma.j.issn.2095-8773.2015.03.005

Abstract

Abstract:

Objective

To analyze the clinicopathological characteristics and prognostic factors associated with primary adenosquamous carcinoma (ASC) of the lung.

Methods

The clinical data of patients with ASC of the lung confirmed by postoperative pathology between October 2008 and December 2014 in Shanghai Chest Hospital were retrospectively analyzed. The 3-year overall survival, 5-year overall survival and 5-year disease-free survival of patients was analyzed, and the prognostic factors for overall survival and disease-free survival were explored by univariate analysis and multivariate analysis.

Results

A total of 205 patients were identified, including 145 (70.7%) males and 60(9.3%) females with an average age of (60.7±9.7) years (range 21-70 years). There were significant differences in the prognosis among patients with N0, N1 and N2(N0 vs N1, P=0.031; N1 vs N2, P=0.037) and among patients with Ⅰ, Ⅱ and ⅢA(Ⅰ vs Ⅱ, P=0.021; Ⅱ vs ⅢA, P=0.007). Cox multivariate analysis demonstrated that T stage of tumor(P=0.011), TNM stage (P<0.001) and adjuvant chemotherapy(P=0.008) were independent prognostic factors for overall survival, and TNM stage (P<0.001) and adjuvant chemotherapy(P=0.005) were independent prognostic factors for disease-free survival.

Conclusions

The prognosis of ASC is associated with T stage and TNM stage, and postoperative adjuvant chemotherapy can increase the survival of patients with ASC.

Key words: Adenosquamous carcinoma, Surgery, Survival

Haitang Yang, Feng Yao, Yifeng Sun, Keke Yu, Haiyong Gu, Tianxiang Chen, Heng Zhao. Clinical outcomes of primary adenosquamous carcinoma of the lung treated by surgery[J]. Chinese Journal of Thoracic Surgery(Electronic Edition), 2015, 02(03): 161-167.

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References 23

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特征		例数(%)
性别		?
?	男性	145 (70.7)
?	女性	60 (29.3)
年龄(±s，岁)		60.7±9.7
吸烟史		?
?	否	80 (39.0)
?	是	125 (61.0)
位置		?
?	中央型	45 (22.0)
?	周围型	160 (78.0)
切除方式		?
?	肺叶切除	161 (78.5)
?	扩大切除	44 (21.5)
脏层胸膜浸润		?
?	否	96 (46.8)
?	是	109 (53.2)
肿瘤直径(cm)		?
?	≤3	73 (35.6)
?	>3	132 (64.4)
T分期		?
?	T1期	40 (19.5)
?	T2期	136 (66.3)
?	T3期	29 (14.1)
N分期		?
?	N0期	99 (48.3)
?	N1期	37 (18.0)
?	N2期	69 (33.7)
TNM分期		?
?	Ⅰ期	82 (40.0)
?	Ⅱ期	43 (21.0)
?	ⅢA期	80 (39.0)

特征		例数(%)
性别		?
?	男性	145 (70.7)
?	女性	60 (29.3)
年龄(±s，岁)		60.7±9.7
吸烟史		?
?	否	80 (39.0)
?	是	125 (61.0)
位置		?
?	中央型	45 (22.0)
?	周围型	160 (78.0)
切除方式		?
?	肺叶切除	161 (78.5)
?	扩大切除	44 (21.5)
脏层胸膜浸润		?
?	否	96 (46.8)
?	是	109 (53.2)
肿瘤直径(cm)		?
?	≤3	73 (35.6)
?	>3	132 (64.4)
T分期		?
?	T1期	40 (19.5)
?	T2期	136 (66.3)
?	T3期	29 (14.1)
N分期		?
?	N0期	99 (48.3)
?	N1期	37 (18.0)
?	N2期	69 (33.7)
TNM分期		?
?	Ⅰ期	82 (40.0)
?	Ⅱ期	43 (21.0)
?	ⅢA期	80 (39.0)

病理学特征			例数(%)
术前误诊			?
?	SCC		026(12.7)
?	低分化癌		020(9.8)
?	AC		019(9.3)
?	大细胞癌		001(0.5)
T分期			?
?	T1期		040(19.5)
?	?	T1a期	013(6.3)
?	?	T1b期	027(13.2)
?	T2期		136(66.3)
?	?	T2a期	112(54.6)
?	?	T2b期	024(11.7)
?	T3期		029(14.1)
N分期			?
?	N0期		099(48.3)
?	N1期		037(18.0)
?	N2期		069(33.7)
TNM分期			?
?	Ⅰ期		082(40.0)
?	?	ⅠA期	022(10.7)
?	?	ⅠB期	060(29.3)
?	Ⅱ期		043(21.0)
?	?	ⅡA期	033(16.1)
?	?	ⅡB期	010(4.9)
?	ⅢA期		080(39.0)

病理学特征			例数(%)
术前误诊			?
?	SCC		026(12.7)
?	低分化癌		020(9.8)
?	AC		019(9.3)
?	大细胞癌		001(0.5)
T分期			?
?	T1期		040(19.5)
?	?	T1a期	013(6.3)
?	?	T1b期	027(13.2)
?	T2期		136(66.3)
?	?	T2a期	112(54.6)
?	?	T2b期	024(11.7)
?	T3期		029(14.1)
N分期			?
?	N0期		099(48.3)
?	N1期		037(18.0)
?	N2期		069(33.7)
TNM分期			?
?	Ⅰ期		082(40.0)
?	?	ⅠA期	022(10.7)
?	?	ⅠB期	060(29.3)
?	Ⅱ期		043(21.0)
?	?	ⅡA期	033(16.1)
?	?	ⅡB期	010(4.9)
?	ⅢA期		080(39.0)

因素		例数(%)	DFS			OS
因素		例数(%)	平均数(±s，月)	t值	P值	平均数(±s，月)	t值	P值
性别		?	?	0.014	0.905	?	0.046	0.831
?	男性	145 (70.7)	40.6±2.6	?	?	50.7±2.4	?	?
?	女性	60 (29.3)	37.3±3.6	?	?	47.4±3.9	?	?
年龄(岁)		?	?	0.016	0.898	?	0.204	0.652
?	≤60	94 (45.9)	40.5±3.0	?	?	49.4±2.9	?	?
?	>60	111 (54.1)	37.8±3.0	?	?	49.4±2.8	?	?
吸烟史		?	?	1.400	0.237	?	1.052	0.305
?	否	80 (39.0)	42.4±2.8	?	?	51.7±2.6	?	?
?	是	125 (61.0)	34.3±3.1	?	?	45.7±3.1	?	?
位置		?	?	0.145	0.703	?	0.035	0.852
?	中央型	45 (22.0)	35.4±4.1	?	?	45.4±3.5	?	?
?	周围型	160 (78.0)	40.8±2.5	?	?	50.6±2.3	?	?
脏层胸膜浸润		?	?	12.39	0.211	?	1.767	0.184
?	否	96 (46.8)	43.4±3.4	?	?	52.8±3.1	?	?
?	是	109 (53.2)	35.1±2.5	?	?	46.6±2.5	?	?
肿瘤大小(cm)		?	?	0.959	0.327	?	2.318	0.128
?	≤3	73 (35.6)	41.0±3.4	?	?	52.9±3.2	?	?
?	>3	132 (64.4)	38.6±2.7	?	?	47.9±2.6	?	?
因素		例数(%)	DFS			OS
因素		例数(%)	平均数(±s，月)	t值	P值	平均数(±s，月)	t值	P值
T分期		?	?	15.88	<0.001	?	26.90	<0.001^a
?	T1期	40 (19.5)	43.3±4.7	?	?	56.0±4.4	?	?
?	T2期	136 (66.3)	42.7±2.8	?	?	52.5±2.5	?	?
?	T3期	29 (14.1)	21.0±3.1	?	?	29.0±3.5	?	?
N分期		?	?	46.61	<0.001	?	29.30	<0.001
?	N0期	99 (48.3)	53.8±3.1	?	?	60.4±2.6	?	?
?	N1期	37 (18.0)	34.7±4.5	?	?	45.8±4.3	?	?
?	N2期	69 (33.7)	22.1±2.7	?	?	35.1±3.2	?	?
TNM分期		?	?	49.68	<0.001	?	34.79	<0.001
?	Ⅰ期	82 (40.0)	56.3±3.4	?	?	63.0±2.8	?	?
?	Ⅱ期	43 (21.0)	38.8±3.9	?	?	47.9±3.6	?	?
?	ⅢA期	80 (39.0)	22.8±2.6	?	?	35.2±3.0	?	?
辅助治疗		?	?	4.363	0.037	?	4.883	0.027
?	是	143 (69.8)	43.2±2.7	?	?	53.2±2.4	?	?
?	否	62 (30.2)	31.8±3.4	?	?	42.2±3.5	?	?

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