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Adenosquamous Lung Carcinoma: Clinical Characteristics, Treatment, and Prognosis

1987; Elsevier BV; Volume: 44; Issue: 5 Linguagem: Inglês

10.1016/s0003-4975(10)62102-9

1552-6259

Keith S. Naunheim, J. R. Taylor, C Skosey, Philip C. Hoffman, Mark K. Ferguson, H M Golomb, Alex G. Little,

Cholangiocarcinoma and Gallbladder Cancer Studies

Adenosquamous carcinoma of the lung is a rare and poorly described entity.At the University of Chicago between 1974 and 1985, 2.3% (20/873) of patients with lung cancer had well-differentiated adenosquamous carcinoma.As in non-small cell lung cancer, patients with Stage I disease were amenable to operation with 60% (315) free from disease between one and six years postoperatively.However, Stage 111 adenosquamous carcinoma (14 patients) exhibited highly aggressive behavior with rapid progression of disease (mean interval, 2.1 months).Despite combinations of surgery (6 patients), chemotherapy (6 patients, one response), and radiotherapy (10 patients, no response), median survival for patients with Stage 111 adenosquamous carcinoma was 5.0 months, worse than that for Stage I11 small cell cancer (9.6 months), adenocarcinoma (9.0 months), and squamous cancer (7.8 months).Most bronchogenic carcinomas can be classified into one of four well-recognized cell types (squamous, large cell, small cell, and adenocarcinoma) using light microscopy and the standard classification system of the World Health Organization (WHO) [l].Tumors with mixed histology, that is, adenosquamous carcinoma, are seen less often.Within the last decade, the heterogeneity of bronchogenic carcinomas has been recognized with increasing frequency using both light microscopic [2], cytological [3], and ultrastructural [4-71 methods of study.Nevertheless, patients whose tumors harbor both glandular and squamous differentiation at the light microscopic level are rare [8, 91, and the biological behavior and clinical characteristics of these adenosquamous lung cancers have not been well described.For this reason we reviewed our cases of adenosquamous carcinoma with regard to symptomatology, histology, tumor stage, treatment, and prognosis. Material and MethodsBetween October, 1974, and June, 1985, 873 patients with a diagnosis of bronchogenic carcinoma were treated at the University of Chicago Medical Center.Twenty-six patients were diagnosed as having adeno-