Clinical characteristics and prognosis of patients with lung adenosquamous carcinoma after surgical resection: results from two institutes.

ABSTRACT

BACKGROUND: Adenosquamous carcinoma (ASC) is a mixed glandular and squamous cell carcinoma (SCC) with more aggressive behavior than the other histologic subtypes of lung cancer. We aim to evaluate the prognosis of patients with ASC after surgical resection. METHODS: We reviewed records of patients who underwent surgical resection for lung cancer in two institutes between January 2010 and December 2015. Survival data were collected with a median follow-up of 59 (range from 10 to 85) months. Kaplan-Meier survival curve was determined for all patients. RESULTS: Patients with ASC accounted for 1.6% of all NSCLC patients (33 males, 25 females). The cumulative postoperative 3- and 5-year survival rates were 56% and 48%, respectively. Overall survival (OS) was significantly lower in ASC patients than in adenocarcinoma (AC) patients operated during the same period (P<0.01). Patients with ASC containing acinar predominant AC had better survival than those with non-acinar predominant ASC (P=0.03). No difference of OS was found in patients with or without visceral pleural invasion (VPI), vascular invasion (VI) or EGFR mutation status. Multivariate analysis showed gender, pathological subtype, and TNM staging to be independent prognostic factors. CONCLUSIONS: We demonstrated that ASC were uncommon and aggressive lung tumors. Predominant histological subtype of AC might be an independent prognostic factor for ASC. Further prospective studies are warranted to clarify the characteristics of this rare tumor.