Squamous cell carcinoma of the lung natural history, complications, and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Shanshan Cen, M.D. [2] Maria Fernanda Villarreal, M.D. [3]
Overview
If left untreated, squamous cell carcinoma of the lung progression occurs slowly and is then followed by local invasion to lymph nodes and distant metastasis.[1] Squamous cell carcinoma of the lung is a locally aggressive tumor, commonly occurs in adult patients between 65 to 74 years. Common sites of metastasis include liver, adrenal gland, bone, and brain. Complications of squamous cell carcinoma of the lung, include: pneumonia, pleural effusion, metastasis, and Horner's syndrome. The 5-year survival rate of patients with squamous cell carcinoma of the lung, depends on the stage at diagnosis. The average survival rate ranges from 49% to 16%.[1] Features associated with worse prognosis are the presence of genetic and histologic factors (such as, presence of necrosis), performance status, tumor size, presence of lymphatic invasion, invasion to the pulmonary artery, presence of satellite lesions, and presence of regional or distant metastases. Prognosis is generally regarded as poor, the 5-year recurrence rate of non-small cell lung cancer is 24%.[1]
Natural History
- The majority of lung cancers present with advanced disease because the symptoms tend to occur later in the course of the disease.[2]
- The patient experiences non-specific symptoms such as cough, hemoptysis, dyspnea, chest pain, dysphonia, dysphagia, lack of appetite, weight loss, and fatigue from 3 weeks to 3 months before seeking medical attention.
- While of duration of symptoms, the tumor cell may double 20 times.[2]
- In more advanced disease, the tumor may spread to other organs such as the spinal cord, brain, and bone.
- These patients may develop symptoms such as leg weakness, paresthesias, bladder dysfunction, seizures, hemiplegia, cranial nerve palsies, confusion , personality changes, skeletal pain, and pleuritic pain.[2]
- Once the cancer spreads to the other organs, it is most likely fatal.
Complications
- Common complications of squamous cell carcinoma of the lung, include:[1]
- Pneumonia
- Pleural effusion
- Metastasis
- Horner's syndrome
Prognosis
- The presence of metastasis is associated with a particularly poor prognosis
- The 5-year survival rate of patients with squamous cell carcinoma of the lung, depends on the stage at diagnosis
- The average survival rate ranges from 49% to 16%.[1]
- Features associated with worse prognosis, include:
- Poorly differentiated tumor, and presence of necrosis
- Poor performance status
- Presence of lymphatic invasion
- Invasion to the pulmonary artery
- Presence of satellite lesions
- Presence of regional or distant metastases
- Prognosis is generally regarded as poor, the 5-year recurrence rate of squamous cell carcinoma of the lung is 15%.[1]
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Soares M, Darmon M, Salluh JI, Ferreira CG, Thiéry G, Schlemmer B, Spector N, Azoulay E (2007). "Prognosis of lung cancer patients with life-threatening complications". Chest. 131 (3): 840–6. doi:10.1378/chest.06-2244. PMID 17356101.
- ↑ 2.0 2.1 2.2 Leary, A (2012). Lung cancer a multidisciplinary approach. Chichester, West Sussex, UK Ames, Iowa: Wiley-Blackwell. ISBN 9781405180757.