Abstract
-
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.
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Keywords: Bronchoscopy; Lung cancer
Fig. 1.Keplan-meier curves of the over all survival of patients according to tumor location.
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) |
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 |
|
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 |
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