|
Basaloid carcinoma of the lung: a really dismal histologic variant?Ann
Thorac Surg. 2003 Dec;76(6):1833-7.
BACKGROUND:
Basaloid carcinoma of the lung has been reported as an uncommon and
highly aggressive form of nonsmall cell lung cancers. Even in stage I
and II of basaloid carcinoma, a 5-year survival rate of only 15% has
been reported and it has been suggested that different treatment
modalities for basaloid carcinoma should be considered. The aim of
this study was to determine the prognostic implications of a basaloid
carcinoma of the lung. METHODS: This study included a series of 291
surgically resected lung tumors, which were originally diagnosed as a
poorly or undifferentiated carcinoma, a small cell carcinoma, or an
atypical carcinoid. Of these, 35 basaloid carcinoma patients were
identified and compared with 167 poorly differentiated squamous cell
carcinoma (PDSC) patients in terms of the preoperative clinical data,
the procedure performed, and the survival outcome. RESULTS: The
overall incidence of basaloid carcinoma was 4.8%. The actuarial 5-year
survival rate was 40.6% in patients with PDSC and 36.5% in those with
basaloid carcinoma (p = 0.86). In stage I and II patients, the
actuarial 5-year survival rate was 53.9% in the PDSC group and 57.2%
in the basaloid group (p = 0.97). There were no differences in the
recurrence rate and the relapse pattern (p = 0.584). Cox's
proportional hazards model revealed that an age equal to 60 years old
(hazard ratio 2.179, p = 0.000) and an advanced stage (hazard ratio
2.264, p = 0.000) were the risk factors for postoperative survival in
both groups. CONCLUSIONS: Basaloid carcinoma of the lung does not have
a worse prognosis than the other nonsmall cell lung cancers. Although
it is obvious that a basaloid carcinoma is a unique histologic entity,
it does not require a different treatment modality due to the similar
clinical behavior with other nonsmall cell lung cancers. |