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Vol.39 No.1 contents | Japanese/English |
- Original Article -
Subclassification of Noguchi's Type C Adenocarcinoma of the Lung
Kenji Suzuki1,2, Tomoyuki Yokose2, Junji Yoshida1, Mitsuyo Nishimura1, Kenro Takahashi1, Kanji Nagai1 and Yutaka Nishiwaki11Division of Thoracic Oncology, National Cancer Center Hospital East, Chiba, Japan, 2Pathology Division, National Cancer Center Research Institute East, Chiba, Japan
Many reports dealt with the prognostic significance of central collapse/fibrosis in adenocarcinoma of the lung, since Shimosato et al. denied the concept of "scar carcinoma" in 1980. Most of reports focused on the characteristics of the central collapse/fibrosis, and there has been no report on the prognostic significance of the ratio of the size of central collapse/fibrosis to that of the tumor. We retrospectively studied 100 adenocarcinomas of the lung 3.0 cm or less in maximum tumor dimension to assess the prognostic significance of the ratio of the size of central collapse/fibrosis to that of the tumor. The ratio was determined by the division of maximum tumor dimension with the maximum dimension of central fibrosis on conventional hematoxylin and eosin stain. The overall 5-year survival rate was 75%. In 26 adenocarcinomas in which the maximum dimension of the central fibrosis was less than 30% that of the maximum tumor dimension, the 5-year survival was 91%. The 5-year survival of the 35 cases in which the central fibrosis was more than 60% that of the maximum tumor dimension was 61%. Adenocarcinoma with central fibrosis 30% or less in relation to the maximum tumor dimension tended to be associated with type A or type B adenocarcinomas as defined by Noguchi et al. In multivariate analysis, the ratio of central fibrosis was an independent prognostic factor, as significant as vascular invasion and locoregional lymph node involvement (p=0.041, 0.008, and 0.031, respectively). In type C adenocarcinoma as defined by Noguchi et al., cases in which the maximum dimension of central fibrosis was less than 50% of that of the tumor had a 5-year survival rate of 85%, while other type C adenocarcinomas had a 5-year survival of only 52% (p<0.05). The ratio of the size of the maximum dimension of central fibrosis to that of the tumor was an independent prognostic factor for peripheral lung adenocarcinoma, and was as significant as other well-established prognostic factors such as vascular invasion and lymph node metastasis.
key words: Classification of small adenocarcinoma defined by Noguchi et al., Limited surgery, Prognostic factor, Multivariate analysis
Received: October 7, 1998
Accepted: November 9, 1998
JJLC 39 (1): 3-11, 1999
