Comprehensive pathological analyses in lung squamous cell carcinoma: Single cell invasion, nuclear diameter, and tumor budding are independent prognostic factors for worse outcomes Journal Article

   

Authors:	Kadota, K.; Nitadori, J. I.; Woo, K. M.; Sima, C. S.; Finley, D. J.; Rusch, V. W.; Adusumilli, P. S.; Travis, W. D.
Article Title:	Comprehensive pathological analyses in lung squamous cell carcinoma: Single cell invasion, nuclear diameter, and tumor budding are independent prognostic factors for worse outcomes
Abstract:	Introduction: For lung squamous cell carcinomas, there are no pathological findings that have been universally accepted as prognostic factors, with the exception of pathological stage. Tumor budding and nuclear grade have been recognized as a poor prognostic factor in other carcinomas. In this study, we investigated whether pathological findings could determine prognosis in lung squamous cell carcinomas. Methods: All available tumor slides from patients with surgically resected, solitary lung squamous cell carcinomas (1999-2009) were reviewed (n = 485; stage I/II/III, 281/136/68). Tumors were evaluated for differentiation, subtypes (keratinizing, nonkeratinizing, basaloid pattern, papillary growth, and clear cell feature), tumor nest size (tumor budding and single cell invasion), and nuclear grade (nuclear diameter and mitosis). Overall survival (OS) was estimated using the Kaplan-Meier method (stratified by pathological stage), and group differences were investigated using the stratified log-rank test and the Cox proportional hazards model. Results: OS was significantly decreased in patients with versus without single cell invasion (p = 0.002 for the entire tumor and p = 0.001 for tumor edge), with large versus small nuclei (p = 0.011), and with high versus low grade tumor budding (p < 0.001 for maximum and p = 0.007 for total). In multivariate analyses, single cell invasion (hazard ratio [HR], 1.47-1.49), nuclear diameter (HR, 1.09-1.33), and tumor budding (HR, 1.04) were independent prognostic factors of OS. However, histologic subtyping including keratinizing, nonkeratinizing, basaloid, and clear cell subtypes did not show prognostic significance. Conclusions: Pathological factors can help stratify prognosis in patients with lung squamous cell carcinomas. Copyright © 2014 by the International Association for the Study of Lung.
Keywords:	squamous cell carcinoma; pathology; lung; prognosis
Journal Title:	Journal of Thoracic Oncology
Volume:	9
Issue:	8
ISSN:	1556-0864
Publisher:	Elsevier Inc.
Date Published:	2014-08-01
Start Page:	1126
End Page:	1139
Language:	English
DOI:	10.1097/jto.0000000000000253
PROVIDER:	scopus
PUBMED:	24942260
PMCID:	PMC4806792
DOI/URL:	http://www.scopus.com/inward/record.url?eid=2-s2.0-84905923362&partnerID=40&md5=6fce97773f40bec155f5eda5cb9a7d09
Notes:	Export Date: 2 September 2014 -- Source: Scopus

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