Clinical significance of the ‘not otherwise specified’ subtype in candidates for resectable non‑small cell lung cancer

Tane,Shinya; Nishio,Wataru; Ogawa,Hiroyuki; Hokka,Daisuke; Tane,Kenta; Tanaka,Yugo; Tauchi,Shunsuke; Uchino,Kazuya; Sakai,Yasuhiro; Ohbayashi,Chiho; Yoshimura,Masahiro; Maniwa,Yoshimasa

doi:10.3892/ol.2014.2302

September-2014 Volume 8 Issue 3

Full Size Image

Journals

International Journal of Molecular Medicine

International Journal of Molecular Medicine is an international journal devoted to molecular mechanisms of human disease.

International Journal of Oncology

International Journal of Oncology is an international journal devoted to oncology research and cancer treatment.

Molecular Medicine Reports

Covers molecular medicine topics such as pharmacology, pathology, genetics, neuroscience, infectious diseases, molecular cardiology, and molecular surgery.

Oncology Reports

Oncology Reports is an international journal devoted to fundamental and applied research in Oncology.

Experimental and Therapeutic Medicine

Experimental and Therapeutic Medicine is an international journal devoted to laboratory and clinical medicine.

Oncology Letters

Oncology Letters is an international journal devoted to Experimental and Clinical Oncology.

Biomedical Reports

Explores a wide range of biological and medical fields, including pharmacology, genetics, microbiology, neuroscience, and molecular cardiology.

Molecular and Clinical Oncology

International journal addressing all aspects of oncology research, from tumorigenesis and oncogenes to chemotherapy and metastasis.

World Academy of Sciences Journal

Multidisciplinary open-access journal spanning biochemistry, genetics, neuroscience, environmental health, and synthetic biology.

International Journal of Functional Nutrition

Open-access journal combining biochemistry, pharmacology, immunology, and genetics to advance health through functional nutrition.

International Journal of Epigenetics

Publishes open-access research on using epigenetics to advance understanding and treatment of human disease.

Medicine International

An International Open Access Journal Devoted to General Medicine.

September-2014 Volume 8 Issue 3

Full Size Image

Article Open Access

Clinical significance of the ‘not otherwise specified’ subtype in candidates for resectable non‑small cell lung cancer

Authors:
- Shinya Tane
- Wataru Nishio
- Hiroyuki Ogawa
- Daisuke Hokka
- Kenta Tane
- Yugo Tanaka
- Shunsuke Tauchi
- Kazuya Uchino
- Yasuhiro Sakai
- Chiho Ohbayashi
- Masahiro Yoshimura
- Yoshimasa Maniwa
View Affiliations / Copyright

Affiliations: Division of Thoracic Surgery, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan, Department of Thoracic Surgery, Hyogo Cancer Center, Akashi, Hyogo 673‑8558, Japan, Division of Pathology, Kobe University Graduate School of Medicine, Kobe, Hyogo 650‑0017, Japan, Division of Pathology, Nara Medical University, Kashihara, Nara 634‑8521, Japan
Pages: 1017-1024
|
Published online on: July 1, 2014

https://doi.org/10.3892/ol.2014.2302
Expand metrics +

Abstract

The histological subtype of non‑small‑cell lung cancer (NSCLC) is a significant factor when selecting treatment strategies. However, cases are occasionally encountered that are diagnosed as ‘not otherwise specified’ (NOS) prior to surgery, due to an uncertain histological subtype. The present study investigated the prognostic significance of the NOS subtype for patients with resectable NSCLC. Between 2001 and 2011, 1,913 patients were diagnosed with NSCLC using transbronchial biopsy and underwent surgical resection at two facilities in Japan. Of these patients, 151 (7.9%) were pre‑operatively diagnosed with NSCLC‑NOS (NOS group) and the remainder had confirmed histological subtypes (confirmed group). The present study compared the clinicopathological features and prognoses of these groups. Analyses of resected specimens revealed that pleomorphic cell carcinoma, large cell neuroendocrine cell carcinoma, large cell carcinoma and adenosquamous carcinoma were significantly more common in the NOS group than in the confirmed group (P<0.001, P=0.002, P=0.019 and P=0.014, respectively). The five‑year survival rate was significantly poorer in the NOS group (60.5 vs. 67.1%; P=0.010), particularly for stage I disease (70.8 vs. 80.7%; P=0.007). The results of a multivariate analysis of overall survival indicated that NOS was a significant independent prognostic factor (hazard ratio, 1.40; 95% confidence interval, 1.02‑1.86; P=0.041). These results indicated that pre‑operative NOS was significantly associated with poorer survival, including for stage I disease. In conjunction with other clinicopathological parameters, NOS can be a useful prognostic factor when deciding on a treatment strategy for NSCLC.

View Figures

View References

1	Johnson DH, Fehrenbacher L, Novotny WF, et al: Randomized phase II trial comparing bevacizumab plus carboplatin and paclitaxel with carboplatin and paclitaxel alone in previously untreated locally advanced or metastatic non-small-cell lung cancer. J Clin Oncol. 22:2184–2191. 2004.
2	Scagliotti G, Hanna N, Fossella F, et al: The differential efficacy of pemetrexed according to NSCLC histology: a review of two Phase III studies. Oncologist. 14:253–263. 2009.
3	Mok TS, Wu YL, Thongprasert S, et al: Gefitinib or carboplatin-paclitaxel in pulmonary adenocarcinoma. N Engl J Med. 361:947–957. 2009.
4	Ou SH and Zell JA: Carcinoma NOS is a common histologic diagnosis and is increasing in proportion among non-small cell lung cancer histologies. J Thorac Oncol. 4:1202–1211. 2009.
5	Suzuki K, Asamura H, Kusumoto M, Kondo H and Tsuchiya R: ‘Early’ peripheral lung cancer: prognostic significance of ground glass opacity on thin-section computed tomographic scan. Ann Thorac Surg. 74:1635–1639. 2002.
6	Hattori A, Suzuki K, Matsunaga T, et al: Is limited resection appropriate for radiologically ‘solid’ tumors in small lung cancers? Ann Thorac Surg. 94:212–215. 2012.
7	Sobin L and Wittekind CH: TNM Classification of Malignant Tumours. 6th edition. Wiley-Liss; New York: pp. 99–103. 2002
8	Travis WD, Brambilla E, Müller-Hermelink HK and Harris CC: World Health Organization Classification of Tumours. Pathology & Genetics. Tumours of the Lung, Pleura, Thymus and Heart. IARC Press; Lyon: 2004
9	Warth A, Muley T, Herpel E, et al: Large-scale comparative analyses of immunomarkers for diagnostic subtyping of non-small-cell lung cancer biopsies. Histopathology. 61:1017–1025. 2012.
10	Travis WD, Rekhtman N, Riley GJ, et al: Pathologic diagnosis of advanced lung cancer based on small biopsies and cytology: a paradigm shift. J Thorac Oncol. 5:411–414. 2010.
11	Travis WD, Brambilla E, Noguchi M, et al: International association for the study of lung cancer/american thoracic society/european respiratory society international multidisciplinary classification of lung adenocarcinoma. J Thorac Oncol. 6:244–285. 2011.
12	Sigel CS, Moreira AL, Travis WD, et al: Subtyping of non-small cell lung carcinoma: a comparison of small biopsy and cytology specimens. J Thorac Oncol. 6:1849–1856. 2011.
13	da Cunha Santos G, Lai SW, Saieg MA, et al: Cyto-histologic agreement in pathologic subtyping of non small cell lung carcinoma: review of 602 fine needle aspirates with follow-up surgical specimens over a nine year period and analysis of factors underlying failure to subtype. Lung Cancer. 77:501–506. 2012.
14	Yasufuku K, Nakajima T, Chiyo M, Sekine Y, Shibuya K and Fujisawa T: Endobronchial ultrasonography: current status and future directions. J Thorac Oncol. 2:970–979. 2007.
15	Nakajima T, Yasufuku K, Fujiwara T, et al: Endobronchial ultrasound-guided transbronchial needle aspiration for the diagnosis of intrapulmonary lesions. J Thorac Oncol. 3:985–988. 2008.
16	Yuki T, Sakuma T, Ohbayashi C, et al: Pleomorphic carcinoma of the lung: a surgical outcome. J Thorac Cardiovasc Surg. 134:399–404. 2007.
17	Raveglia F, Mezzetti M, Panigalli T, et al: Personal experience in surgical management of pulmonary pleomorphic carcinoma. Ann Thorac Surg. 78:1742–1747. 2004.
18	Okada M, Nishio W, Sakamoto T, et al: Effect of tumor size on prognosis in patients with non-small cell lung cancer: the role of segmentectomy as a type of lesser resection. J Thorac Cardiovasc Surg. 129:87–93. 2005.
19	Okada M, Koike T, Higashiyama M, Yamato Y, Kodama K and Tsubota N: Radical sublobar resection for small-sized non-small cell lung cancer: a multicenter study. J Thorac Cardiovasc Surg. 132:769–775. 2006.
20	Varlotto JM, Medford-Davis LN, Recht A, et al: Identification of stage I non-small cell lung cancer patients at high risk for local recurrence following sublobar resection. Chest. 143:1365–1377. 2013.
21	Sakr L, Roll P, Payan MJ, et al: Cytology-based treatment decision in primary lung cancer: is it accurate enough? Lung Cancer. 75:293–299. 2012.
22	Scott WJ, Howington J, Feigenberg S, Movsas B and Pristers K; American College of Chest Physicians. Treatment of non-small cell lung cancer stage I and stage II: ACCP evidence-based clinical practice guidekines (2nd edition). Chest. 132(3 Suppl): 234S–242S. 2007.

Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Clinical significance of the ‘not otherwise specified’ subtype in candidates for resectable non‑small cell lung cancer

This article is mentioned in:

Abstract

Figure 1

Figure 2

Figure 3

Figure 4

Related Articles