Prognostic significance of CT-emphysema score in patients with advanced squamous cell lung cancer.
BACKGROUND
Although emphysema is a known independent risk factor of lung cancer, no study has addressed the prognostic impact of computed tomography (CT)-emphysema score in advanced stage lung cancer.


METHODS
For 84 consecutive patients with stage IIIB and IV squamous cell lung cancer that underwent palliative chemotherapy, severity of emphysema was semi-quantitatively scored using baseline chest CT images according to the Goddard scoring system (possible scores range, 0-24). The cutoff of high CT-emphysema score was determined using the maximum chi-squared test and the prognostic significance of the high CT-emphysema score was evaluated using Kaplan-Meier analysis and Cox proportional hazards analysis.


RESULTS
The median CT-emphysema score was 5 (range, 0-22). Patients with a high CT-emphysema score (≥4) tended to have poorer overall survival (OS) (median: 6.3 vs. 13.7 months) than those with a score of <4 (P=0.071). Multivariable analysis revealed that a higher CT-emphysema score was a significant independent prognostic factor for poor OS [hazard ratio (HR) =2.06; 95% confidence interval (CI), 1.24-3.41; P=0.005), along with no response to first-line therapy (P=0.009) and no second-line therapy (P<0.001).


CONCLUSIONS
CT-emphysema score is significantly associated with poor prognosis in patients with advanced squamous cell lung cancer.
Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea ;
Young Saing
YS
Kim
Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Eun Young
EY
Kim
Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea ;
Hee Kyung
HK
Ahn
Division of Hematology and Oncology, Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Republic of Korea ;
Eun Kyung
EK
Cho
Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Yu Mi
YM
Jeong
Department of Radiology, Gachon University Gil Medical Center, Incheon, Republic of Korea.
Jeong Ho
JH
Kim
CT-emphysema score; chemotherapy; lung cancer; prognosis; squamous cell carcinoma