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Original Article
Characteristics of Peripheral versus Central Lung Cancer Since 2000
So Young Ock, Tae Won Jang, You Jin Han, Go Eun Yeo, Eun Jung Kim, Won Hyoung Lee, Nam Kyu Kim
Kosin Medical Journal 2014;29(1):47-52.
DOI: https://doi.org/10.7180/kmj.2014.29.1.47
Published online: December 17, 2014
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Department of Internal Medicine, College of Medicine, Kosin University, Busan, Korea

Corresponding Author: So Young Ock, Deparment of Internal Medicine, College of Medicine, Kosin University, 34 Amnamdong, Seo-gu, Busan, 602-702, Korea TEL: +82-51-990-6460 FAX: +82-51-990-3049 E-mail: oaksoyoung@naver.com
• Received: July 30, 2013   • Revised: February 8, 2014   • Accepted: February 12, 2014

Copyright © 2014 Kosin University School of Medicine Proceedings

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

  • Objectives
    The aim of this study was to explore the changes of bronchoscopic features according to epidemiologic change of lung cancer.
  • Methods
    We performed a retrospective review of the clinical characteristics of 1,139 lung cancer patient who underwent bronchoscopy at Kosin University Hospital from January 2000 to December 2010.
  • Results
    The age of patients increased significantly during the last decade (P < 0.001). The most common histological type was adenocarcinoma (38.1%), followed by squamous carcinoma (35.7%) and small cell carcinoma (15.3%). There was an increasing incidence of adenocarcinoma over the time (P < 0.001). Bronchoscopic feature were divided into two classes; central type, peripheral type. The peripheral type was predominant (62.3%). The proportion of peripheral type has been increased in process of time (49.7% vs. 63.7% vs. 73.7%; P < 0.01). Among the major histopathologic type of lung cancer, adenocarcinoma (81.3%) and unclassifiable non-small-cell lung cancer (73.4%), small cell carcinoma (56.9%) were associated with preferential occurrence of peripheral type. Squamous cell carcinoma of the lung more often arised in central type (59%). However, the proportion of peripheral squamous cell carcinoma has been increased. On the subgroup analysis, the median survival time of peripheral type with adenocarcinoma and small cell carcinoma were longer than central type (P < 0.05).
  • Conclusions
    The age of the lung cancer patients at diagnosis was getting older. The most frequent histopathologic type was adenocarcinoma. The proportion of peripheral type lung cancer gradually increased over the time. The survival time of peripheral type lung cancer was longer than central type.
Fig. 1.
Keplan-meier curves of the over all survival of patients according to tumor location.
kmj-29-47f1.jpg
Table 1.
Patient characteristics
Characteristic No. of patients (%)
Age (years) 64 ± 9.9
Gender  
Male 910 (79.9)
Female 229 (20.1)
Smoking status  
Current smoker or ever smoker 508 (72.1)
Never smoker 197 (27.9)
ECOG  
0-1 739 (65.3)
2-4 393 (34.7)
Treatment  
Operation 169 (15)
Chemotherapy 501 (44)
Rradiation or Concurrent chemoradiotherapy 191 (17)
Best supportive care 276 (24)

No: Number, ECOG: Eastern Cooperative Oncology Group.

Table 2.
Annual trends of clinical characteristics of lung cancer in Kosin University
  2000-2003 2004-2004 2008-2010 P-value
No of patients (%) 380 (33.4) 386 (33.9) 373 (32.7)  
Age, yr (mean ± SD) 62.0 ± 10.753 64.1 ± 9.374 65.2 ± 9.450 <0.001
ADC/Non-ADC 32.1/67.9 37.3/62.7 42.4/57.6 0.014
Smoker/non-smoker 69.9/30.1 72.4/27.6 72.9/27.1 0.783
Stage (%)        
I-II/III/IV 9.0/51.2/39.8 15.6/41.4/42.9 15.2/37.1/47.6 0.002
L/E 40.4/59.6 47.4/52.6 41.4/58.6 0.761
Treatment       0.001
Surgery 10.3 17.9 16.4  
Radiation & Chemoradiotherpy 16.8 23.3 10  
Chemotherapy 41.3 39.6 51.5  
BSC 31.6 19.2 22.1  
Central/peripheral type 50.3/49.7 36.3/63.7 26.3/73.7 <0.0001
Polyphoid lesion 12.9 10.9 9.4  
Nodular lesion 25 19.9 10.5  
Subepithelial lesion 12.4 5.4 6.4  
No endobronchial lesion 49.7 63.7 73.7  

ADC: adenocarcinoma, ECOG: Eastern Cooperative Oncology, Group, L: limited, E: extensive, BSC: best supportive care.

Table 3.
Comparison clinical characteristics central type lung cancer with periphera lung cancer
  Central type Peripheral type P-value
No of patients (%) 429 (37.7) 710 (62.3)  
Age, yr (mean ±10.753 64 ± 10.46 64 ± 9.70 0.214
ADC/Non-ADC 18.2/81.8 48.7/51.3 0.001
Smoker/non-smoker 83.1/16.9 66.2/33.8 0.001
Smoking, pack-yrs 41.5 39.8 0.373
ECOG 0-1/2-4 65.1/34.9 65.4/34.6 0.484
Stage (%)      
I-II/III/IV 12.7/49.7/37.6 13.6/39.6/46.8 0.007
L/E 50.0/50.0 50.4/49.6 0.534
Survival time (month) 14.5 16.7 0.001
Adenocarcioma 14.5 ± 0.294 17.4 ± 0.443 0.001
Squamus cell 12.8 ± 2.917 12.8 ± 1.082 0.961
NSCLC 14.9 ± 1.628 15.5 ± 1.230 0.218
Small cell 14.2 ± 0.805 15.7 ± 0.995 0.038

ADC: adenocarcinoma, ECOG: Eastern Cooperative Oncology, Group, L: limited, E: extensive.

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