Histologic grade is an independent prognostic factor for survival in non-small cell lung cancer: An analysis of 5018 hospital- and 712 population-based cases

Zhifu D Sun, Marie Christine Aubry, Claude Deschamps, Randolph Stuart Marks, Scott Heitaka Okuno, Brent A. Williams, Hiroshi Sugimura, V. Shane Pankratz, Ping Yang

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Abstract

Objective: Our objective was to determine whether histologic grade independently contributes to the prognosis of non-small cell lung cancer. Methods: A total of 5018 hospital-based patients diagnosed from 1997 to 2003 and 712 population-based patients diagnosed from 1984 to 2003 were followed up through the end of 2004. The effect of histologic grade on postdiagnosis survival or postresection recurrence was evaluated by Cox proportional hazards models. Relative risks (RR) were estimated by comparing undifferentiated, poorly differentiated, and moderately differentiated carcinoma with well-differentiated carcinoma. Results: Histologic grade was significantly associated with survival after adjustment for the effects of age, gender, smoking history, tumor stage, histologic cell type, and treatment modality. Patients with undifferentiated carcinoma had an 80% elevated risk of death (RR = 1.83; 95% confidence interval [CI], 1.4-2.4) compared with those with well-differentiated carcinoma; 70% and 40% elevated risks were observed for patients with poorly and moderately differentiated carcinoma, respectively (RR, 1.7 [1.5-2.0] and 1.4 [1.2-1.6]). Similar results were observed for 718 incidence cases in which the relative risks were 1.6 (1.1-2.2) and 1.4 (1.0-1.9) for poorly/undifferentiated carcinoma and moderately differentiated carcinoma, respectively. Patients with less-differentiated carcinoma after tumor resection had a higher risk of recurrence, with adjusted hazard ratios of 2.1 (95% CI: 1.4-2.9) and 1.4 (1.0-1.9) for poorly/undifferentiated and moderately differentiated carcinoma compared with well-differentiated carcinoma. Conclusions: Histologic grade has significant prognostic value for survival of patients with non-small cell lung cancer. Histologic grade may provide useful information in defining the aggressiveness of tumors and should be considered as an independent factor affecting survival beyond TNM staging.

Original languageEnglish (US)
Pages (from-to)1014-1020
Number of pages7
JournalJournal of Thoracic and Cardiovascular Surgery
Volume131
Issue number5
DOIs
StatePublished - May 2006

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Non-Small Cell Lung Carcinoma
Carcinoma
Survival
Population
Confidence Intervals
Recurrence
Neoplasms
Neoplasm Staging
Proportional Hazards Models
Smoking
History
Incidence

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Surgery

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Histologic grade is an independent prognostic factor for survival in non-small cell lung cancer : An analysis of 5018 hospital- and 712 population-based cases. / Sun, Zhifu D; Aubry, Marie Christine; Deschamps, Claude; Marks, Randolph Stuart; Okuno, Scott Heitaka; Williams, Brent A.; Sugimura, Hiroshi; Pankratz, V. Shane; Yang, Ping.

In: Journal of Thoracic and Cardiovascular Surgery, Vol. 131, No. 5, 05.2006, p. 1014-1020.

Research output: Contribution to journalArticle

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title = "Histologic grade is an independent prognostic factor for survival in non-small cell lung cancer: An analysis of 5018 hospital- and 712 population-based cases",
abstract = "Objective: Our objective was to determine whether histologic grade independently contributes to the prognosis of non-small cell lung cancer. Methods: A total of 5018 hospital-based patients diagnosed from 1997 to 2003 and 712 population-based patients diagnosed from 1984 to 2003 were followed up through the end of 2004. The effect of histologic grade on postdiagnosis survival or postresection recurrence was evaluated by Cox proportional hazards models. Relative risks (RR) were estimated by comparing undifferentiated, poorly differentiated, and moderately differentiated carcinoma with well-differentiated carcinoma. Results: Histologic grade was significantly associated with survival after adjustment for the effects of age, gender, smoking history, tumor stage, histologic cell type, and treatment modality. Patients with undifferentiated carcinoma had an 80{\%} elevated risk of death (RR = 1.83; 95{\%} confidence interval [CI], 1.4-2.4) compared with those with well-differentiated carcinoma; 70{\%} and 40{\%} elevated risks were observed for patients with poorly and moderately differentiated carcinoma, respectively (RR, 1.7 [1.5-2.0] and 1.4 [1.2-1.6]). Similar results were observed for 718 incidence cases in which the relative risks were 1.6 (1.1-2.2) and 1.4 (1.0-1.9) for poorly/undifferentiated carcinoma and moderately differentiated carcinoma, respectively. Patients with less-differentiated carcinoma after tumor resection had a higher risk of recurrence, with adjusted hazard ratios of 2.1 (95{\%} CI: 1.4-2.9) and 1.4 (1.0-1.9) for poorly/undifferentiated and moderately differentiated carcinoma compared with well-differentiated carcinoma. Conclusions: Histologic grade has significant prognostic value for survival of patients with non-small cell lung cancer. Histologic grade may provide useful information in defining the aggressiveness of tumors and should be considered as an independent factor affecting survival beyond TNM staging.",
author = "Sun, {Zhifu D} and Aubry, {Marie Christine} and Claude Deschamps and Marks, {Randolph Stuart} and Okuno, {Scott Heitaka} and Williams, {Brent A.} and Hiroshi Sugimura and Pankratz, {V. Shane} and Ping Yang",
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T1 - Histologic grade is an independent prognostic factor for survival in non-small cell lung cancer

T2 - An analysis of 5018 hospital- and 712 population-based cases

AU - Sun, Zhifu D

AU - Aubry, Marie Christine

AU - Deschamps, Claude

AU - Marks, Randolph Stuart

AU - Okuno, Scott Heitaka

AU - Williams, Brent A.

AU - Sugimura, Hiroshi

AU - Pankratz, V. Shane

AU - Yang, Ping

PY - 2006/5

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N2 - Objective: Our objective was to determine whether histologic grade independently contributes to the prognosis of non-small cell lung cancer. Methods: A total of 5018 hospital-based patients diagnosed from 1997 to 2003 and 712 population-based patients diagnosed from 1984 to 2003 were followed up through the end of 2004. The effect of histologic grade on postdiagnosis survival or postresection recurrence was evaluated by Cox proportional hazards models. Relative risks (RR) were estimated by comparing undifferentiated, poorly differentiated, and moderately differentiated carcinoma with well-differentiated carcinoma. Results: Histologic grade was significantly associated with survival after adjustment for the effects of age, gender, smoking history, tumor stage, histologic cell type, and treatment modality. Patients with undifferentiated carcinoma had an 80% elevated risk of death (RR = 1.83; 95% confidence interval [CI], 1.4-2.4) compared with those with well-differentiated carcinoma; 70% and 40% elevated risks were observed for patients with poorly and moderately differentiated carcinoma, respectively (RR, 1.7 [1.5-2.0] and 1.4 [1.2-1.6]). Similar results were observed for 718 incidence cases in which the relative risks were 1.6 (1.1-2.2) and 1.4 (1.0-1.9) for poorly/undifferentiated carcinoma and moderately differentiated carcinoma, respectively. Patients with less-differentiated carcinoma after tumor resection had a higher risk of recurrence, with adjusted hazard ratios of 2.1 (95% CI: 1.4-2.9) and 1.4 (1.0-1.9) for poorly/undifferentiated and moderately differentiated carcinoma compared with well-differentiated carcinoma. Conclusions: Histologic grade has significant prognostic value for survival of patients with non-small cell lung cancer. Histologic grade may provide useful information in defining the aggressiveness of tumors and should be considered as an independent factor affecting survival beyond TNM staging.

AB - Objective: Our objective was to determine whether histologic grade independently contributes to the prognosis of non-small cell lung cancer. Methods: A total of 5018 hospital-based patients diagnosed from 1997 to 2003 and 712 population-based patients diagnosed from 1984 to 2003 were followed up through the end of 2004. The effect of histologic grade on postdiagnosis survival or postresection recurrence was evaluated by Cox proportional hazards models. Relative risks (RR) were estimated by comparing undifferentiated, poorly differentiated, and moderately differentiated carcinoma with well-differentiated carcinoma. Results: Histologic grade was significantly associated with survival after adjustment for the effects of age, gender, smoking history, tumor stage, histologic cell type, and treatment modality. Patients with undifferentiated carcinoma had an 80% elevated risk of death (RR = 1.83; 95% confidence interval [CI], 1.4-2.4) compared with those with well-differentiated carcinoma; 70% and 40% elevated risks were observed for patients with poorly and moderately differentiated carcinoma, respectively (RR, 1.7 [1.5-2.0] and 1.4 [1.2-1.6]). Similar results were observed for 718 incidence cases in which the relative risks were 1.6 (1.1-2.2) and 1.4 (1.0-1.9) for poorly/undifferentiated carcinoma and moderately differentiated carcinoma, respectively. Patients with less-differentiated carcinoma after tumor resection had a higher risk of recurrence, with adjusted hazard ratios of 2.1 (95% CI: 1.4-2.9) and 1.4 (1.0-1.9) for poorly/undifferentiated and moderately differentiated carcinoma compared with well-differentiated carcinoma. Conclusions: Histologic grade has significant prognostic value for survival of patients with non-small cell lung cancer. Histologic grade may provide useful information in defining the aggressiveness of tumors and should be considered as an independent factor affecting survival beyond TNM staging.

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