Treatment for Patients With Early Stage Adenosquamous Lung Cancer

INTRODUCTION: Adenosquamous lung cancer (ASC) is a rare type of NSCLC with poor prognosis. There is no consensus on the necessity of adjuvant chemotherapy and the selection of surgical procedures for patients with early stage lung cancer. Few studies have investigated the treatment for early stage ASC. METHODS: All cases of TNM stage I ASC as per the seventh edition of the American Joint Committee on Cancer staging system were identified from the Surveillance, Epidemiology, and End Results database from 2004 to 2016. The prognostic factors of the primary cohort were identified. Clinical characteristics, first-line treatments, surgical procedures, and survival data, including overall survival and cancer-specific survival, were analyzed. RESULTS: A total of 1251 patients were included. The mean age of the patients was 70 years (±9.5 y). Male and white patients accounted for larger proportions. There were 656 and 595 patients with stages IA and IB, respectively. The mean tumor size was 26.2 mm (±10.7 mm). With respect to the treatment, 139 patients who received only chemotherapy had the worst prognosis. Similar outcomes were observed in both the surgery and adjuvant therapy groups. Nevertheless, adjuvant chemotherapy could improve survival outcomes of patients with a tumor size of 4 to 5 cm. Of the 1075 patients who underwent surgery, there were 224 cases of sublobar resection, 834 cases of lobectomy, and 17 cases of extended or sleeve lobectomy. The results revealed that patients who underwent lobectomy had better prognosis. CONCLUSIONS: Early stage ASC has a poor prognosis. Adjuvant chemotherapy was found to have no considerable benefit in patients with stage I disease (eighth edition). Lobectomy or other radical surgeries are recommended as they can improve overall survival of patients with ASC.