Researchers from Keio University School of Medicine (Tokyo, Japan) and Saiseikai Utsunomiya Hospital (Utsunomiya City, Japan) have identified potential prognostic factors for squamous cell carcinoma (SCC), a type of non-small-cell lung cancer. The findings were recently published in the Journal of Thoracic Oncology.
Worldwide, lung cancer is the main cause of cancer-related deaths and SCC accounts for 20–30% of all non-small-cell lung cancers. Depending on their primary location, SCC is classified as either central, which is most prevalent, or as peripheral (p-SCC). While the incidence of p-SCC is increasing, the clinical and biological behaviors are yet to be understood.
To identify potential prognostic factors, the researchers evaluated several clinical and pathological variables in 280 patients who had undergone surgical removal of p-SCC. The results revealed that low preoperative levels of SSC antigen in the serum or with the absence of tumor invasion into the pleura or the lack of tumor vasculature are independent prognostic factors for patients with any stage of p-SCC. The patients exhibiting these prognostic factors had an extended period without recurrence of the disease and longer overall survival. This was also observed in the subgroup of patients with early stage I disease.
“Our study revealed that p-SCCs with pleural or vascular invasion or high serum SCC antigen are more likely to recur than those without it; even in stage I patients. Pleural and/or vascular invasion are thought to be essential steps in the progression and metastasis of p-SCCs and high serum SCC antigen may suggest micrometastases at the time of surgery,” explain the authors. “Patients with high serum SCC levels, vascular invasion or pleural invasion should have their tumor stage upgraded in order to reflect the clear differences in survival. Clinical trials should be performed to evaluate if postoperative chemotherapy would benefit these patients who typically may not receive chemotherapy because of their early stage.”