Clinical characteristics and prognosis of basaloid squamous cell carcinoma of the lung: a population-based analysis

Guangda Yuan; Cheng Zhan; Yiwei Huang; Donglin Zhu; Hongya Xie; Tengteng Wei; Tao Lu; Qun Wang; Yong Yang; Yimeng Zhu

doi:10.7717/peerj.6724

Clinical characteristics and prognosis of basaloid squamous cell carcinoma of the lung: a population-based analysis

PeerJ. 2019 Apr 30:7:e6724. doi: 10.7717/peerj.6724. eCollection 2019.

Authors

Guangda Yuan¹, Cheng Zhan², Yiwei Huang², Donglin Zhu¹, Hongya Xie¹, Tengteng Wei¹, Tao Lu², Qun Wang², Yong Yang¹, Yimeng Zhu¹

Affiliations

¹ Department of Thoracic Surgery, The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou,Jiangsu, China.
² Department of Thoracic Surgery, Zhongshan Hospital, Fudan University, Shanghai, China.

Abstract

Background: This study analyzed the clinical features and prognosis of basaloid squamous cell carcinoma of the lung (BSC), and constructed a nomogram to predict the prognoses of patients.

Methods: The information of pure BSC patients was obtained in the Surveillance, Epidemiology, and End Results database between 2004 and 2015. Then, it was evaluated, and compared with the data of lung squamous cell carcinoma (SCC), lung large cell carcinoma (LCC) and lung adenocarcinoma (LAC) patients. Subsequently, we used univariate and multivariate analyses to investigate the independent factors related to the prognoses of patients with BSC and constructed a nomogram to verify the prognoses.

Results: A total of 425 patients diagnosed with BSC were enrolled. Compared with patients with SCC, LCC and LAC, the mean survival time of BSC patients was better than all of them. Compared with SCC, there were significant differences between the characteristics of grade (P < 0.001), total stage (P < 0.001), T stage (P < 0.001), N stage (P < 0.001), M stage (P < 0.001), surgery (P < 0.001), radiotherapy (P < 0.001), and chemotherapy (P < 0.001), while BSC also had significantly different clinical characteristics from LCC and LAC. Univariate and multivariate survival analyses showed that age (P < 0.001), T stage (P < 0.001), N stage (P = 0.009), M stage (P < 0.001), and surgery (P < 0.001) were independent prognostic factors of BSC. The survival of patients undergoing lobectomy was significantly better than sublobar resection, with an OR of 0.389 (0.263-0.578). We constructed a nomogram with a C-index of 0.750 (95% confidence interval) based on the results of multivariate analysis. The calibration curves based on nomogram scores indicated that the nomogram could accurately predict the prognosis of patients.

Conclusions: BSC had unique clinical and prognostic features. T stage, N stage, M stage, age, and surgery were independently associated with overall survival (OS). Lobectomy was a relative ideal choice for patients with BSC. The nomogram effectively predicted the OS at 1-, 3-, and 5-years.

Keywords: Basaloid squamous cell carcinoma (BSC); Clinical characteristics; Nomogram; SEER database.

Grants and funding

This work was supported by the Suzhou Industry Technology Innovation Program (SYSD2017172), and the Suzhou Science and Technology Development Program (SYSD2018135). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.