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W.S. Krimsky
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P1.04 - Poster Session/ Biology, Pathology, and Molecular Testing (ID 233)
- Event: WCLC 2015
- Type: Poster
- Track: Biology, Pathology, and Molecular Testing
- Presentations: 1
- Moderators:
- Coordinates: 9/07/2015, 09:30 - 17:00, Exhibit Hall (Hall B+C)
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P1.04-031 - The Changing Anatomic Position of Squamous Cell Carcinoma of the Lung - A New Conundrum (ID 1554)
09:30 - 09:30 | Author(s): W.S. Krimsky
- Abstract
Background:
Traditionally, squamous cell carcinoma of the lung (SqCC) is conceptualized as more of a central rather than a peripheral form of lung cancer. While there is some variability with respect to the definition in the literature of what constitutes the ‘peripheral’ portions of the lung, historically, rates of squamous cell carcinoma in the lung periphery are typically sited in the 15% to 30% range. More recently, and especially in light of the historical data, we increasingly observed that a significant portion of newly diagnosed peripheral lung lesions – perhaps even a majority, appeared to be squamous cell carcinomas. Therefore, a comprehensive review of the tumor data at our facility, a busy teaching hospital with a large cohort of cancer patients, was undertaken to assess whether there had been a substantive change in the traditional epidemiologic distributions of the lung cancer, specifically with respect to squamous cell carcinoma. Given the differences in cell biology and carcinogenesis of different types of cancer, a potential epidemiologic shift might suggest a change in tumor biology, etc.
Methods:
From May 12[th], 2012 through May 13[th] of 2013, all histopathologicallly confirmed diagnoses of squamous cell carcinoma of the lung at our facility were reviewed. Again, while there is some dissonance in the literature with respect to the definition of the ‘periphery’, a reasonable approach given the existing data is to define the lung periphery as the lateral or outer half of the lung with respect to the position of the lesion on the axial cuts of the computed tomography scans of the chest. Each patient’s lesion was then classified as peripheral or central using that definition. Furthermore, various demographic data points for each patient such as age, race, sex, smoking history, use of inhaled corticosteroids, and concomitant use of proton pump inhibitors were also collected and analyzed. In addition, a cohort of patients without a prior history of malignancy was also analyzed as a “de novo” subset.
Results:
During the evaluation period, a total of fifty-six patients were diagnosed with SqCC. Of these, 55% (31/56) had SqCC located in the lung periphery with the remaining 45% (25/56) being found in a central location. Of the 56 patients diagnosed with SqCC, 27 had a prior history of malignancy. These 27 patients were then removed from the analysis in an effort to assess whether this distribution would persist in the remaining 29 patients. This “de novo” SqCC subset was then analyzed. Of this subset of patients, 62% (18/29) had SqCC that were located in the lung periphery and 38% (11/29) had lesions that were located centrally. Other epidemiological features correlated with typical trends seen in patients with SqCC.
Conclusion:
Our findings appear to confirm our initial observation that, within our institution, there has been a substantive shift in the traditional distribution of Squamous Cell Carcinoma with the majority of these cancers now being diagnosed in the lung periphery as opposed to the more central locations. Further work will be needed to confirm these results.
