title: Improved survival associated with a balanced structure between adenomatous and squamous components in patients with adenosquamous carcinoma of the lung.
abstract: BACKGROUND
  Primary adenosquamous carcinoma (ASC) of the lung is rare and its biological behavior has not yet been thoroughly described. The aim of this study was to analyze the clinicopathological characteristics and prognostic factors associated with ASC.
  
  
  METHODS
  Clinical records of patients with ASC of the lung who underwent surgery between October 2008 and December 2014 in a single institution were retrospectively reviewed.
  
  
  RESULTS
  A total of 205 patients were identified. Patients with balanced structural components had significantly better prognosis than those with squamous (p = 0.014) or adenomatous (p < 0.001) predominance, and those with N0, N1, and N2 ASC (N0 vs. N1 [ p = 0.031] and N1 vs. N2 [p = 0.037], respectively), or stage I, II and IIIA ASC (stage I vs. II [p = 0.021] and stage II vs. IIIA [p = 0.007], respectively) had significant differences with respect to overall survival (OS). Multivariate analysis identified structural components (p = 0.011), tumor, node and metastasis (TNM) status (p < 0.001), and adjuvant chemotherapy (p = 0.008) as significantly prognostic factors for OS, and structural components (p = 0.030), TNM stage (p < 0.001) and adjuvant chemotherapy (p = 0.005) as the corresponding variables for disease-free survival.
  
  
  CONCLUSIONS
  A balanced structure between adenomatous and squamous components in patients with primary ASC of the lung was associated with better prognosis.
authors.affiliation: Department of Cardiovascular Surgery of 1st Affiliated Hospital of Soochow University, Suzhou, China.
authors.forename: H
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China; Division of General Thoracic Surgery, Inselspital University Hospital Bern, Bern, Switzerland.
authors.forename: H
authors.initials: H
authors.lastname: Yang
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: F
authors.initials: F
authors.lastname: Yao
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Pulmonary, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: J
authors.initials: J
authors.lastname: Xu
authors.affiliation: Department of Thoracic Surgery, Shanghai Chest Hospital, Shanghai Jiaotong University, Shanghai, China.
authors.forename: H
authors.initials: H
authors.lastname: Gu
authors.affiliation: Department of Cardiovascular Surgery of 1st Affiliated Hospital of Soochow University, Suzhou, China. Electronic address: shen_zhenya@163.com.
authors.forename: Z
authors.initials: Z
authors.lastname: Shen
mesh_terms: D000328:Adult; D000368:Aged; D018196:Carcinoma, Adenosquamous / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008175:Lung Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D012189:Retrospective Studies
keywords: Adenosquamous lung carcinoma; Surgery; Survival