title: Non-Small-cell Lung Cancer Patients With Adenocarcinoma Morphology Have a Better Outcome Compared With Patients Diagnosed With Non-Small-cell Lung Cancer Favor Adenocarcinoma.
abstract: Non-small-cell lung cancer (NSCLC) includes 2 major histologic subtypes: squamous cell carcinoma and non-squamous carcinoma, mainly adenocarcinoma, a distinction that carries significant clinical and therapeutic implications. NSCLC is diagnosed as adenocarcinoma or as squamous cell carcinoma on the basis of histologic parameters. However, when morphology is inconclusive, tumors with immunohistochemistry (IHC) findings characteristic of adenocarcinoma are referred to as "NSCLC favor adenocarcinoma" (NFA). Our aim was to evaluate whether pulmonary adenocarcinoma diagnosis on the basis of morphology had a similar prognosis compared with NFA.
  
  
  
  Patients with advanced NSCLC non-squamous carcinoma who were treated with a platinum-pemetrexed doublet as first-line combination chemotherapy were identified. Demographic, clinical, laboratory, and pathological data including the method of pathological diagnosis (morphology or IHC) was extracted from the clinical charts. The correlation between the various parameters and overall survival was evaluated.
  
  
  
  Lack of adenocarcinoma morphology, male sex, smoking history, and negative thyroid transcription factor 1 IHC were associated with worse prognosis and shorter overall survival in multivariate analysis. High white blood cell count, absolute neutrophil count, neutrophil to lymphocyte ratio, and low albumin levels were associated with shorter overall survival only in univariate analysis.
  
  
  
  Pulmonary adenocarcinoma has a better prognosis than NFA, regarding advanced NSCLC treated with platinum-pemetrexed combination chemotherapy. This distinction should be a stratification factor in clinical trials and a prognostic factor to consider in analysis of previous trials.
authors.affiliation: Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
authors.forename: Iris
authors.initials: I
authors.lastname: Shiran
authors.affiliation: Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
authors.forename: Eyal
authors.initials: E
authors.lastname: Heller
authors.affiliation: Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
authors.forename: Shlomit
authors.initials: S
authors.lastname: Jessel
authors.affiliation: Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
authors.forename: Iris
authors.initials: I
authors.lastname: Kamer
authors.affiliation: Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
authors.forename: Inbal
authors.initials: I
authors.lastname: Daniel-Meshulam
authors.affiliation: Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
authors.forename: Rossie
authors.initials: R
authors.lastname: Navon
authors.affiliation: Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
authors.forename: Damien
authors.initials: D
authors.lastname: Urban
authors.affiliation: Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel.
authors.forename: Amir
authors.initials: A
authors.lastname: Onn
authors.affiliation: Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel. Electronic address: yair.bar@sheba.health.gov.il.
authors.forename: Jair
authors.initials: J
authors.lastname: Bar
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D002289:Carcinoma, Non-Small-Cell Lung / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D000073865:Cigarette Smoking / Q000009:adverse effects; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008168:Lung / Q000378:metabolism* / Q000473:pathology; D008175:Lung Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009504:Neutrophils / Q000473:pathology*; D000068437:Pemetrexed / Q000627:therapeutic use; D017671:Platinum Compounds / Q000627:therapeutic use; D011379:Prognosis; D012737:Sex Factors; D016019:Survival Analysis; D000074482:Thyroid Nuclear Factor 1 / Q000378:metabolism
chemical_list: D017671:Platinum Compounds; D000074482:Thyroid Nuclear Factor 1; D000068437:Pemetrexed
keywords: Immunohistochemistry; NSCLC; Non-squamous; Platinum-pemetrexed doublet; TTF1