How Morphology Shapes Survival in Invasive Squamous Cell Carcinoma of the Lung
Background and Objectives: Squamous cell carcinoma (SQCC) represents a significant proportion of human malignancies affecting various anatomical sites, including the lung. Understanding the prognostic factors is crucial for establishing effective risk stratification in these patients, as multiple cr...
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MDPI AG
2024-10-01
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| author | Angela-Ștefania Marghescu Silviu Vlăsceanu Mădălina Preda Beatrice Mahler Ioana Anca Bădărău Loredana Sabina Cornelia Manolescu Mirela Țigău Cristina Teleagă Corina Elena Toader Alexandru Daniel Radu Alexandru Stoichiță Mariana Costache |
| author_facet | Angela-Ștefania Marghescu Silviu Vlăsceanu Mădălina Preda Beatrice Mahler Ioana Anca Bădărău Loredana Sabina Cornelia Manolescu Mirela Țigău Cristina Teleagă Corina Elena Toader Alexandru Daniel Radu Alexandru Stoichiță Mariana Costache |
| author_sort | Angela-Ștefania Marghescu |
| collection | DOAJ |
| description | Background and Objectives: Squamous cell carcinoma (SQCC) represents a significant proportion of human malignancies affecting various anatomical sites, including the lung. Understanding the prognostic factors is crucial for establishing effective risk stratification in these patients, as multiple critical aspects significantly impact overall survival. Materials and Methods: A retrospective study was conducted on 99 patients with operable lung SQCC treated at a tertiary center. The exclusion criteria included patients under 18, those with in situ or metastatic SQCC, and those who received neoadjuvant therapy. The surgical specimens were re-analyzed, and data were collected on multiple variables, including pTNM staging, tumor characteristics, and overall survival (OS). The Kaplan–Meier survival analysis and Cox regression models were used to identify significant prognostic factors. Results: The Kaplan–Meier analysis showed a median survival of 36 months with a 65.65% mortality rate. Significant factors influencing survival included keratinization, histological grading, tumor size and stage, pleural invasion, tumor cell arrangement, tumor budding, spread through air space (STAS), and mitotic index. A multiple Cox regression highlighted the nonkeratinizing tumors, advanced pT stages, single-cell invasion, and high mitotic index as key predictors of poorer outcomes. The nonkeratinizing tumors showed higher mortality and shorter median survival rates compared to keratinizing tumors. The tumor staging, cell arrangement, and tumor budding significantly impacted the survival curves. Conclusions: The study underscores the importance of detailed histopathological evaluations in lung SQCC. The nonkeratinizing tumors, advanced pT stage, single-cell invasion, and high mitotic index were associated with higher hazard rates, emphasizing the need for a comprehensive grading system incorporating these factors to improve prognostic accuracy and guide treatment strategies. |
| format | Article |
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| issn | 2075-4418 |
| language | English |
| publishDate | 2024-10-01 |
| publisher | MDPI AG |
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| series | Diagnostics |
| spelling | doaj-art-1a2aea044e204db2a1f56cb620bcdb482025-08-20T02:11:03ZengMDPI AGDiagnostics2075-44182024-10-011420226410.3390/diagnostics14202264How Morphology Shapes Survival in Invasive Squamous Cell Carcinoma of the LungAngela-Ștefania Marghescu0Silviu Vlăsceanu1Mădălina Preda2Beatrice Mahler3Ioana Anca Bădărău4Loredana Sabina Cornelia Manolescu5Mirela Țigău6Cristina Teleagă7Corina Elena Toader8Alexandru Daniel Radu9Alexandru Stoichiță10Mariana Costache11Pathological Anatomy Discipline, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, RomaniaPhysiology III Discipline, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Microbiology, Parasitology and Virology, Faculty of Midwives and Nursing, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, RomaniaPneumoftisiology II Discipline, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, RomaniaPhysiology III Discipline, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Microbiology, Parasitology and Virology, Faculty of Midwives and Nursing, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, RomaniaDepartment of Research, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, RomaniaDepartment of Research, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, RomaniaPathology Department, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, RomaniaDepartment of Research, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, RomaniaDepartment of Research, Marius Nasta Institute of Pneumophthisiology, 050159 Bucharest, RomaniaPathological Anatomy Discipline, Faculty of Medicine, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, RomaniaBackground and Objectives: Squamous cell carcinoma (SQCC) represents a significant proportion of human malignancies affecting various anatomical sites, including the lung. Understanding the prognostic factors is crucial for establishing effective risk stratification in these patients, as multiple critical aspects significantly impact overall survival. Materials and Methods: A retrospective study was conducted on 99 patients with operable lung SQCC treated at a tertiary center. The exclusion criteria included patients under 18, those with in situ or metastatic SQCC, and those who received neoadjuvant therapy. The surgical specimens were re-analyzed, and data were collected on multiple variables, including pTNM staging, tumor characteristics, and overall survival (OS). The Kaplan–Meier survival analysis and Cox regression models were used to identify significant prognostic factors. Results: The Kaplan–Meier analysis showed a median survival of 36 months with a 65.65% mortality rate. Significant factors influencing survival included keratinization, histological grading, tumor size and stage, pleural invasion, tumor cell arrangement, tumor budding, spread through air space (STAS), and mitotic index. A multiple Cox regression highlighted the nonkeratinizing tumors, advanced pT stages, single-cell invasion, and high mitotic index as key predictors of poorer outcomes. The nonkeratinizing tumors showed higher mortality and shorter median survival rates compared to keratinizing tumors. The tumor staging, cell arrangement, and tumor budding significantly impacted the survival curves. Conclusions: The study underscores the importance of detailed histopathological evaluations in lung SQCC. The nonkeratinizing tumors, advanced pT stage, single-cell invasion, and high mitotic index were associated with higher hazard rates, emphasizing the need for a comprehensive grading system incorporating these factors to improve prognostic accuracy and guide treatment strategies.https://www.mdpi.com/2075-4418/14/20/2264squamous cell carcinomalungsurvivalprognosticmorphological factorsrisk stratification |
| spellingShingle | Angela-Ștefania Marghescu Silviu Vlăsceanu Mădălina Preda Beatrice Mahler Ioana Anca Bădărău Loredana Sabina Cornelia Manolescu Mirela Țigău Cristina Teleagă Corina Elena Toader Alexandru Daniel Radu Alexandru Stoichiță Mariana Costache How Morphology Shapes Survival in Invasive Squamous Cell Carcinoma of the Lung Diagnostics squamous cell carcinoma lung survival prognostic morphological factors risk stratification |
| title | How Morphology Shapes Survival in Invasive Squamous Cell Carcinoma of the Lung |
| title_full | How Morphology Shapes Survival in Invasive Squamous Cell Carcinoma of the Lung |
| title_fullStr | How Morphology Shapes Survival in Invasive Squamous Cell Carcinoma of the Lung |
| title_full_unstemmed | How Morphology Shapes Survival in Invasive Squamous Cell Carcinoma of the Lung |
| title_short | How Morphology Shapes Survival in Invasive Squamous Cell Carcinoma of the Lung |
| title_sort | how morphology shapes survival in invasive squamous cell carcinoma of the lung |
| topic | squamous cell carcinoma lung survival prognostic morphological factors risk stratification |
| url | https://www.mdpi.com/2075-4418/14/20/2264 |
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