title: Prognostic factors based on clinicopathological data among the patients with resected peripheral squamous cell carcinomas of the lung.
abstract: BACKGROUND
  Although the incidence of peripheral squamous cell carcinomas (p-SqCCs) of the lung has increased over recent years, clinicopathological factors influencing prognosis of resected p-SqCCs remain unclear.
  
  
  METHODS
  We examined 280 patients who underwent complete resection of SqCCs and analyzed the clinicopathological features in relation to their overall survival (OS) and recurrence-free survival (RFS) according to the primary location.
  
  
  RESULTS
  Multivariate analysis of all stages of p-SqCCs patients revealed that high serum squamous cell carcinoma antigen (SCC) level (OS; p < 0.01, RFS; p < 0.01), vascular invasion (OS; p < 0.01, RFS; p < 0.01), pleural invasion (OS; p = 0.03, RFS; p = 0.01), nodal metastasis (OS; p = 0.02) and complication with lung disease (OS; p < 0.01) were independently unfavorable prognostic factors. Among stage I p-SqCCs patients, high serum SCC level (OS; p < 0.01, RFS; p < 0.01), vascular invasion (RFS; p < 0.01) and pleural invasion (RFS; p = 0.01) were also strongly correlated with poor prognosis independently. When we reevaluated the survival rate, T1 p-SqCCs with high serum SCC level or vascular invasion can be upgraded to T2a. Patients with stage IB had a significantly poorer prognosis than stage IA (5-year RFS; 61.4 % versus 76.6 %, p < 0.05).
  
  
  CONCLUSIONS
  High serum SCC level, pleural and vascular invasions were independent poor prognostic factors for completely resected p-SqCCs. T1 p-SqCCs with high serum SCC level or vascular invasion should be upgraded to T2a, which accurately reflect survival status among patients with p-SqCCs.
authors.affiliation: *Division of General Thoracic Surgery, Department of Surgery, Keio University School of Medicine, Tokyo, Japan; †Department of General Thoracic Surgery, Saiseikai Utsunomiya Hospital, Tochigi, Japan; and ‡Department of Pathology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Tomonari
authors.initials: T
authors.lastname: Kinoshita
authors.forename: Takashi
authors.initials: T
authors.lastname: Ohtsuka
authors.forename: Tai
authors.initials: T
authors.lastname: Hato
authors.forename: Taichiro
authors.initials: T
authors.lastname: Goto
authors.forename: Ikuo
authors.initials: I
authors.lastname: Kamiyama
authors.forename: Atsushi
authors.initials: A
authors.lastname: Tajima
authors.forename: Katsura
authors.initials: K
authors.lastname: Emoto
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Mitsutomo
authors.initials: M
authors.lastname: Kohno
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate