Prognosis of advanced stage non-small-cell lung cancer patients receiving chemotherapy: adenocarcinoma versus squamous cell carcinoma

  • Noorwati Soetandyo Department of Hematology and Medical Oncology, Dharmais National Cancer Center Hospital, Jakarta, Indonesia http://orcid.org/0000-0001-8822-8488
  • Arif Riswahyudi Hanafi Department of Pulmonology, Dharmais National Cancer Center Hospital, Jakarta, Indonesia
  • Sri Agustini Department of Hematology and Medical Oncology, Dharmais National Cancer Center Hospital, Jakarta, Indonesia
  • Dian Triana Sinulingga Dharmais National Cancer Center Hospital, Jakarta, Indonesia
Keywords: chemotherapy, histology, lung cancer, prognosis
Abstract viewed: 306 times
PDF downloaded: 129 times
HTML downloaded: 55 times
EPUB downloaded: 166 times

Abstract

BACKGROUND In Indonesia, lung cancer is one of the most prevalent solid cancer with the highest mortality rate. However, studies to identify prognostic factors associated with mortality are lacking. Thus, this study was aimed to determine the association of histological subtypes and prognosis of advanced stage non-small-cell lung cancer (NSCLC) patients receiving chemotherapy.

METHODS This study focused on a retrospective cohort consisting of 60 patients with advanced stage NSCLC and treated with chemotherapy. Patients with NSCLC stage IIIB or stage IV, age ≥18 years, and good performance status were recruited. The outcomes were one-year mortality and treatment response. Gender, age, body mass index, staging, and performance status were evaluated. Chi-square and Fisher’s exact tests were used.

RESULTS Two common histological subtypes, adenocarcinoma (68.3%) and squamous cell carcinoma (31.7%), were observed among all subjects. Four patients (6.7%) died during one-year observation period. Mortality rate was higher in squamous cell carcinoma (10.5%) patients than in adenocarcinoma (4.9%). Underweight patients had higher risk of death (relative risk [RR] = 1.09, 95% confidence interval [CI] = 1.00–1.19) and disease progression (RR = 1.30, 95% CI = 1.12–1.51). In adenocarcinoma, metastasis was a risk for progressive disease (RR = 1.35, 95% CI = 1.09–1.66). In squamous cell carcinoma, men had a lower risk of disease progression (RR = 0.11, 95% CI = 0.03–0.41).

CONCLUSIONS Squamous cell carcinoma had comparable one-year mortality and disease progression rate with adenocarcinoma type in advanced stage NSCLC. However, underweight patients had a higher risk of mortality and disease progression.

References

  1. Rafiemanesh H, Mehtarpour M, Khani F, Hesami SM, Shamlou R, Towhidi F, et al. Epidemiology, incidence and mortality of lung cancer and their relationship with the development index in the world. J Thorac Dis. 2016;8(6):1094-102. https://doi.org/10.21037/jtd.2016.03.91

  2. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. https://doi.org/10.3322/caac.21492

  3. Cheng TY, Cramb SM, Baade PD, Youlden DR, Nwogu C, Reid ME. The international epidemiology of lung cancer: latest trends, disparities, and tumor characteristics. J Thorac Oncol. 2016;11(10):1653-71. https://doi.org/10.1016/j.jtho.2016.05.021

  4. Postmus PE, Kerr KM, Oudkerk M, Senan S, Waller DA, Vansteenkiste J, et al. Early and locally advanced non-small-cell lung cancer (NSCLC): ESMO clinical practice guidelines for diagnosis, treatment and follow-up. Ann Oncol. 2017 Jul;28(suppl_4):iv1-21. https://doi.org/10.1093/annonc/mdx222

  5. Hu XL, Xu ST, Wang XC, Hou DN, Chen CC, Song YL, et al. Prevalence of and risk factors for presenting initial respiratory symptoms in patients undergoing surgery for lung cancer. J Cancer. 2018;9(19):3515-21. https://doi.org/10.7150/jca.26209

  6. Ettinger DS, Wood DE, Aisner DL, Akerley W, Bauman J, Chirieac LR, et al. Non-small cell lung cancer, version 5.2017, NCCN clinical practice guidelines in oncology. J Natl Compr Canc Netw. 2017;15(4):504-35. https://doi.org/10.6004/jnccn.2017.0050

  7. Harrison LD, Zhang-Salomons J, Mates M, Booth CM, King WD, Mackillop WJ. Comparing effectiveness with efficacy: outcomes of palliative chemotherapy for non-small-cell lung cancer in routine practice. Curr Oncol. 2015;22(3):184-91. https://doi.org/10.3747/co.22.2419

  8. Xia W, Yu X, Mao Q, Xia W, Wang A, Dong G, et al. Improvement of survival for non-small cell lung cancer over time. Onco Targets Ther. 2017;10:4295-303. https://doi.org/10.2147/OTT.S145036

  9. Rinaldi S, Berardi R. Lung cancer prognosis: can histological patterns and morphological features have a role in the management of lung cancer patients? Ann Transl Med [Internet]. 2017;5(17):353. https://doi.org/10.21037/atm.2017.05.18

  10. Berardi R, Rinaldi S, Santoni M, Newsom-Davis T, Tiberi M, Morgese F, et al. Prognostic models to predict survival in patients with advanced non-small cell lung cancer treated with first-line chemo- or targeted therapy. Oncotarget. 2016;7(18):26916-24. https://doi.org/10.18632/oncotarget.8309

  11. Mäkitaro R, Pääkko P, Huhti E, Bloigu R, Kinnula VL. Prospective population-based study on the survival of patients with lung cancer. Eur Respir J. 2002;19(6):1087-92. https://doi.org/10.1183/09031936.02.00048302

  12. Ichinose Y, Hara N, Ohta M, Yano T, Maeda K, Asoh H, et al. Is T factor of the TNM staging system a predominant prognostic factor in pathologic stage I non-small-cell lung cancer ? A multivariate prognostic factor analysis of 151 patients. J Thorac Cardiovasc Surg. 1993;106(1):90-4. https://doi.org/10.1016/S0022-5223(19)33744-4

  13. Ferguson MK, Wang J, Hoffman PC, Haraf DJ, Olak J, Masters GA, et al. Sex-associated differences in survival of patients undergoing resection for lung cancer. Ann Thorac Surg. 2000;69(1):245-50. https://doi.org/10.1016/S0003-4975(99)01078-4

  14. Mahesh PA, Archana S, Jayaraj BS, Patil S, Chaya SK, Shashidhar HP, et al. Factors affecting 30-month survival in lung cancer patients. Indian J Med Res. 2012;136(4):614-21.

  15. Olaussen KA, Postel-Vinay S. Predictors of chemotherapy efficacy in non-small-cell lung cancer: a challenging landscape. Ann Oncol. 2016;27(11):2004-16. https://doi.org/10.1093/annonc/mdw321

  16. Edge SB, Compton CC. The American Joint Committee on Cancer: the 7th edition of the AJCC cancer staging manual and the future of TNM. Ann Surg Oncol. 2010;17(6):1471-4. https://doi.org/10.1245/s10434-010-0985-4

  17. Travis WD, Brambilla E, Nicholson AG, Yatabe Y, Austin JHM, Beasley MB, et al. The 2015 World Health Organization classification of lung tumors: impact of genetic, clinical and radiologic advances since the 2004 classification. J Thorac Oncol. 2015;10(9):1243-60. https://doi.org/10.1097/JTO.0000000000000630

  18. Schwartz LH, Litière S, de Vries E, Ford R, Gwyther S, Mandrekar S, et al. RECIST 1.1-update and clarification: from the RECIST committee. Eur J Cancer. 2016;62:132-7. https://doi.org/10.1016/j.ejca.2016.03.081

  19. Harsal A, Suratman E, Tambunan T. Overview of lung cancer in Dharmais National Cancer Hospital, Jakarta, Indonesia. J Thorac Oncol. 2007;2(8):S564. https://doi.org/10.1097/01.JTO.0000283652.11456.81

  20. Wu YL, Zhou Q. Lung cancer management in the Asia-Pacific region: what's the difference compared with the United States and Europe? Results of the second Asia Pacific Lung Cancer Conference. J Thorac Oncol. 2007;2(6):574-6. https://doi.org/10.1097/01.JTO.0000275341.39960.6c

  21. Thomas A, Chen Y, Yu T, Jakopovic M, Giaccone G. Trends and characteristics of young non-small cell lung cancer patients in the United States. Front Oncol. 2015;5:113. https://doi.org/10.3389/fonc.2015.00113

  22. Kawase A, Yoshida J, Ishii G, Nakao M, Aokage K, Hishida T, et al. Differences between squamous cell carcinoma and adenocarcinoma of the lung: are adenocarcinoma and squamous cell carcinoma prognostically equal? Jap J Clin Oncol. 2012;42(3):189-95. https://doi.org/10.1093/jjco/hyr188

  23. Simmons CP, Koinis F, Fallon MT, Fearon KC, Bowden J, Solheim TS, et al. Prognosis in advanced lung cancer--A prospective study examining key clinicopathological factors. Lung Cancer. 2015;88(3):304-9. https://doi.org/10.1016/j.lungcan.2015.03.020

  24. Jang RW, Caraiscos VB, Swami N, Banerjee S, Mak E, Kaya E, et al. Simple prognostic model for patients with advanced cancer based on performance status. J Oncol Pract. 2014;10(5):e335-41. https://doi.org/10.1200/JOP.2014.001457

  25. Kawaguchi T, Takada M, Kubo A, Matsumura A, Fukai S, Tamura A, et al. Performance status and smoking status are independent favorable prognostic factors for survival in non-small cell lung cancer: a comprehensive analysis of 26,957 patients with NSCLC. J Thorac Oncol. 2010;5(5):620-30. https://doi.org/10.1097/JTO.0b013e3181d2dcd9

  26. Yuan P, Cao JL, Rustam A, Zhang C, Yuan XS, Bao FC, et al. Time-to-progression of NSCLC from early to advanced stages: an analysis of data from SEER registry and a single institute. Sci Rep. 2016;6:28477. https://doi.org/10.1038/srep28477

  27. Richardson DB, Keil AP, Cole SR, MacLehose RF. Observed and expected mortality in cohort studies. Am J Epidemiol. 2017;185(6):479-86. https://doi.org/10.1093/aje/kww205

  28. Fesinmeyer MD, Goulart B, Blough DK, Buchwald D, Ramsey SD. Lung cancer histology, stage, treatment, and survival in American Indians and Alaska Natives and whites. Cancer. 2010;116(20):4810-6. https://doi.org/10.1002/cncr.25410

  29. Wang J, Xu H, Zhou S, Wang D, Zhu L, Hou J, et al. Body mass index and mortality in lung cancer patients: a systematic review and meta-analysis. Eur J Clin Nutr. 2018;72(1):4-17. https://doi.org/10.1038/ejcn.2017.70

  30. Zhong J, Zheng Q, Gao E, Dong Z, Zhao J, An T, et al. Influence of body mass index on the therapeutic efficacy of gemcitabine plus cisplatin and overall survival in lung squamous cell carcinoma. Thorac cancer. 2018;9(2):291-7. https://doi.org/10.1111/1759-7714.12581

  31. Aoyagi T, Terracina KP, Raza A, Matsubara H, Takabe K. Cancer cachexia, mechanism and treatment. World J Gastrointest Oncol. 2015;7(4):17-29. https://doi.org/10.4251/wjgo.v7.i4.17

  32. Tammemagi CM, Neslund-Dudas C, Simoff M, Kvale P. Smoking and lung cancer survival: the role of comorbidity and treatment. Chest. 2004;125(1):27-37. https://doi.org/10.1378/chest.125.1.27

  33. Pinto JA, Vallejos CS, Raez LE, Mas LA, Ruiz R, Torres-Roman JS, et al. Gender and outcomes in non-small cell lung cancer: an old prognostic variable comes back for targeted therapy and immunotherapy? ESMO Open. 2018;3(3):e000344. https://doi.org/10.1136/esmoopen-2018-000344

  34. Sekine I, Sumi M, Ito Y, Tanai C, Nokihara H, Yamamoto N, et al. Gender difference in treatment outcomes in patients with stage III non-small cell lung cancer receiving concurrent chemoradiotherapy. Japanese J Clin Oncol. 2009;39(11):707-12. https://doi.org/10.1093/jjco/hyp095

Published
2020-03-26
How to Cite
1.
Soetandyo N, Hanafi AR, Agustini S, Sinulingga DT. Prognosis of advanced stage non-small-cell lung cancer patients receiving chemotherapy: adenocarcinoma <em>versus</em&gt; squamous cell carcinoma. Med J Indones [Internet]. 2020Mar.26 [cited 2020Jun.5];29(1):26-1. Available from: https://mji.ui.ac.id/journal/index.php/mji/article/view/3787
Section
Clinical Research